Facing the Future: Standards for Acute General Paediatric Services
Facing the Future provides a vision of how paediatric care can be delivered to provide a safe and sustainable, high-quality service that meets the health needs of every child and young person.
On this page:
- Standards 2015
- Implementation plan 2015
- Workforce implications 2015
- Previous reports - 2013 and 2011
On other pages:
- Standards outside the hospital - Facing the Future Together for Child Health standards apply across the unscheduled care pathway
Five years on from their original publication and in light of national health policy changes, changes to the way that healthcare professionals work and new research and evidence, the RCPCH has revised the standards.
This report sets out ten standards for high quality, safe and sustainable acute general paediatric services. It is essential that paediatrics is a 24 hours a day, seven days a week specialty; with the most experienced doctors present at the busiest times.
The RCPCH believes that these standards will bring a level of consistency to what is currently quite a variable pattern of practice. The intention is to ensure that every child is seen in a timely manner by a suitably experienced doctor.
The standards cannot be met with the current workforce and the current number of inpatient units.
The five key recommendations made in the original report are even more crucial with these revisions to the standards:
- Reduce the number of inpatient sites
- Increase the number of consultants
- Expand significantly the number of registered children’s nurses
- Expand the number of GPs trained in paediatrics
- Decrease the number of paediatric trainees
The RCPCH has developed an implementation plan to support the implementation of the standards across the UK by:
- Supporting and equipping members with the information and skills to influence at a local level
- Supporting services to implement the standards
- Encouraging services to work together in regional networks to implement the standards
- Continuing discussions and negotiation between the RCPCH and key stakeholders at a national policy level
The College plans to carry out an audit of the standards across the UK in 2016/17.
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- Over three quarters (77%) of children see a paediatrician on middle or consultant grade rotas within four hours of admission - just under a quarter do not.
- 88% of children or young people admitted to a paediatric department with an acute medical problem are seen by a consultant paediatrician (or equicalent) within the first 24 hours.
- There is a disparity between care delivered during the day - just 11% (26% of self reported peak times) had a presence during the evening. During peak times at weekends consultant presence was just 6% (20% at self reported peak times).
- Immediate telephone advice is not always available across some specialties - and arrangements are often informal.
- There is a shortfall of staff across all rotas when measured against the Facing the Future standards.
To deal with the challenges facing the service, the College called for urgent service reconfiguration. Paediatric services needed to look at more innovative models of service provision, such as providing more care in the community, to deliver the best possible care to children and young people.
(PDF, 1.95MB, 69 pages)
(PDF, 322KB, 13 pages) - Outlines 10 minimum standards for acute, general paediatric care. These standards are intended to support a safe and sustainable quality paediatric service for children and young people. Each standard is accompanied by an explanation of what the standard aims to achieve, and how the standard was agreed.
Models the potential implications of these standards for paediatric services in the UK. It maps the current acute service configuration in the UK, which inadequately serves the current and future needs of children and young people.Facing the Future proposes possible solutions to these problems, and imagines three possible scenarios for the configuration of inpatient units.
The workforce implications of these scenarios are also explored and concludes that in order to deliver safe and sustainable services the current UK consultant workforce needs to expand from 3,084 WTE consultants to between 4,488 and 4,853 WTE consultants depending on which reconfiguration model is adopted. It also recommends the increased involvement of children’s nurses and GP trainees in some aspects of care.
(PDF, 259KB, 8 pages) - Remote and rural areas account for over four fifths of the UK land mass and include up to a quarter of the UK population. Children and young people represent 22 percent of total rural populations. Due to distance and scattered populations, such areas face a diverse range of problems in the delivery of health services. RCPCH proposed the following standards to ensure the quality and safety of small and remote (S&R) paediatric units within the NHS. These have been developed by a working group of paediatricians for use locally and to support NHS commissioners in the provision of safe local health services for children and young people.
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