A new service for children in North Kirklees is opening at Dewsbury and District Hospital.
The Children’s Assessment Unit, which opens on Monday 11 August 2014, will help young patients to be seen, treated and return home with their families more quickly.
This new eight-bed unit is located next to the Accident and Emergency (A&E) department, allowing the children’s services team to work more closely with doctors and nurses in A&E to:
- See children more quickly
- Make sure they get the right treatment, faster
- Meaning if children don’t need to be in hospital they can go home straight from A&E.
If children do need to be admitted into hospital they will go to the new Children’s Assessment Unit. Specialist children’s doctors and nurses will continue to work at Dewsbury on the Unit and in clinics.
Construction work on the unit started in January 2014. It will take over the assessment and inpatient function of the existing Children’s Ward at Dewsbury (Ward 7). It will operate 24 hours a day, seven days a week until community services are fully developed to support children and young people outside of hospital as part of the Care Closer to Home strategy. This is anticipated to be in 2016/17.
Ward 7 will remain open primarily as an outpatient and day care unit but it will retain 10 beds for children needing an inpatient admission in the event of there being an increase in demand. Ward 7 will also be developed to accommodate the outpatient services provided in the Child Development Unit which will improve patient experience for those using this service, making more space for additional clinics and open access and reducing the need to travel across the site for diagnostic tests or other services.
The opening of the Children’s Assessment Unit represents the first major step for the Trust’s three-year clinical services strategy. Public consultation on the strategy took place in 2013 as part of the Meeting the Challenge campaign which was given support by the Secretary of State for Health in March 2014.
Stephen Eames, Chief Executive of The Mid Yorkshire Hospitals NHS Trust, said: “This unit offers a real improvement for young patients and families in North Kirklees. It will help us see and treat sick or injured children quicker meaning more children will be able to go home without needing to stay overnight in hospital.
“For those who need further observation and treatment, the vast majority of them will get the care they need locally in Dewsbury. For the small number of children who might need to be in hospital for a longer stay, they will be transferred to Pinderfields Hospital where we will eventually be centralising urgent and complex care for all our patients.”
Dr Karen Stone, Consultant Paediatrician at The Mid Yorkshire Hospitals NHS Trust, said: “Good quality and safe care for children is what is at the heart of this development. From our experience at Pinderfields Hospital, we know that an assessment unit next to A&E enables children to be assessed and treated more quickly. The development of more clinics including rapid access clinics and day care on Ward 7 will also be a significant improvement.
“This new model of care means we can still see and treat around 80 per cent of children in Dewsbury who would normally go there. The others who might have serious injuries or conditions will be better cared for in a hospital like Pinderfields with all the necessary people and equipment around them.”
Dr David Kelly, GP and Chair of the North Kirklees Clinical Commissioning Group, said: “We are confident that this model of care is the right one for our patients. Whilst it moves us a step closer to centralising children’s inpatient services in Wakefield, we made a commitment that no beds would be taken out of the hospital until community services were developed sufficiently to manage patients at home more effectively. We are pleased to see that the Trust has honoured this commitment made during consultation.
“We are currently in the process of developing our plans for a range of community-based services for both adults and children. This will ensure that, wherever possible, healthcare is provided at or close to people’s home. We expect these new services to be in place by 2016/17.
“It’s important to say that people should still access local services in the same way, including from their GP and their local hospital.”
Frequently asked questions
Do parents need to do anything differently?
Families across North Kirklees DO NOT need to do anything different as a result of these changes; they can still:
• Seek advice from their pharmacist or online at www.nhs.uk
• Visit their GP practice
• Call 111 if they need help quickly but it is not a medical emergency
• Attend the nearest A&E if their child needs urgent medical attention
• Call 999 in an emergency.
If a child needs urgent and immediate attention parents should continue to call 999 – ambulance staff will assess and stabilise children on site before taking them to the most appropriate unit. This might not be Dewsbury if a child has very serious problems and needs immediate care in a specialist hospital i.e. if they have severe head injuries.
Will this mean a reduction in beds?
Not until services have evidence that fewer beds are needed and that more children can be supported in the community reducing the need for hospital admission in line with commitments made during consultation. We will review the demand and requirements for beds in 2015 and until then there will be eight beds in the Children’s Assessment Unit (CAU) with an additional 10 beds in Ward 7 to cope with any surge in demand.
How can you cope with demand?
This model of care means fewer children will need to be admitted as inpatients. As the CAU is located next to A&E it will mean faster access to clinical opinion and more rapid assessment and treatment. This will reduce the need to admit children into hospital.
In addition, Dewsbury hospital will no longer be admitting children from areas outside Mid Yorkshire as it has in the past – e.g. South Bradford, South Leeds.
The evidence and experience of this model at Pinderfields Hospital has also shown us this is a highly effective way of working and can reduce the need to keep children in hospital unnecessarily.
What community services are being put in place?
Children and young people in North Kirklees are currently supported by dedicated children’s community nurses as required. North Kirklees CCG will shortly be increasing the amount of nursing cover available locally.
North Kirklees CCG is in the process of developing its plans for a range of community-based services for both adults and children, in line with its commissioning intentions. This will ensure that wherever possible, healthcare is provided at or close to home. Services are expected to be in place by 2016/17.
When will services change?
The Children’s Assessment Unit will open in Dewsbury on 11 August. Initially the unit will manage the majority of inpatients and will be open 24/7. The opening hours will be tailored to demand (estimated 12 hours a day) when inpatient paediatrics is centralised at Pinderfields. This will take place in 2016/17 when the community services are in place to support this.
My child has direct access to Ward 7. What will happen to their care?
The families of children with direct access to the ward will not see a change in their care. They will continue to be seen and treated at Dewsbury Hospital. All families of those children with direct access to the children’s ward at Dewsbury have been contacted and their needs have been discussed.
A greater emphasis will be placed on caring for children with complex needs in the community. Children with complex needs such as neuro-disability and diabetes could have most of their care needs met in the community by GPs, community paediatricians, specialist nurses and therapists rather than coming to hospital.
Is this a downgrading of care at Dewsbury?
No – this is an improvement of services across Mid Yorkshire. The new facility will be able to deliver the same care as the facility which was set up at Pinderfields Hospital in 2010.
The measures aim to improve the standard of care for children across Mid Yorkshire by providing them with a swifter diagnosis and make sure the most appropriate care can be offered in the right place, by the right specialists, at the right time.
By 2016 all children’s inpatient care will be provided at Pinderfields. This will enhance children’s services by concentrating the expertise and facilities for children who require this level of care and will ensure that all children requiring admission to hospital receive the highest standards of care.
These changes will help us achieve the ten standards identified by the Royal College of Paediatrics and Child Health (RCPCH) to promote high quality paediatric care. These standards focus on the importance of having a consultant-delivered service in order to improve clinical outcomes and patient experience.
How will this affect consultant cover?
Patients will see no change to consultant cover at Dewsbury Hospital. There will be a dedicated paediatric consultant for the CAU and Ward 7 from 8am until 8pm to ensure children are diagnosed, treated and discharged as quickly as possible. Cover will be provided by a consultant paediatrician on call outside of these hours.
Will there be fewer staff to care for children at Dewsbury?
The number of nurses to patients will remain the same on the new unit as it was on Ward 7. The changes have meant that some staff have been asked to work differently, or in a different location including community roles. This has included opportunities for staff to develop new skills and experience. We have engaged with any staff affected by change.
Will there be 24 hour care at Dewsbury?
Yes. Dewsbury Hospital will have a 24-hour A&E department and the Children’s Assessment Unit. Demand for the CAU will be reassessed in 2016/17 when inpatients are centralised at Pinderfields Hospital. At this stage the assumption is that the unit will be open for 12 hours, seven days a week.
What will happen when a GP needs a decision on where to refer their patient?
Where a GP requests a decision about a child at their surgery, they will still contact the hospital as they do now. They can continue to speak to the paediatrician on call that will then make a decision on whether the child is to be referred to the CAU or elsewhere – e.g. rapid access clinic. Children should still attend their GP surgery before being transferred to the unit where appropriate.
How many children may need to transfer from Dewsbury to other hospitals?
We estimate that we can see and treat at least 80% of children who currently attend Dewsbury Hospital. The rest, around 1 or 2 children per day, might need to be transferred to Pinderfields Hospital for a longer stay.
What support will be in place for parents / visitors who will need to travel between hospitals?
A parent or carer of a child who needs to be transferred by ambulance from Dewsbury will normally be able to travel with their child.
For anyone else (family, friends etc.) the Trust has put in place a free shuttle bus service, the 113, which will operate hourly between 8am and 8pm Monday to Fridays and 1pm to 8pm Saturdays, Sundays and Bank Holidays.
We will be providing parking permits and discount vouchers for the restaurants for some parents and carers if their child is in Pinderfields Hospital for several days.