A snapshot of general paediatric and neonatal services: benchmarking for improvement and recovery

Two new reports have been released outlining the findings of a snapshot survey of the UK's general paediatric and neonatal services and workforce in September 2019. The reports provide a pre-COVID benchmark and give recommendations to government, service planners and other decision makers about how to improve services.

The RCPCH joined forces with the NHS Improvement programme Getting It Right First Time (GIRFT) to run a snapshot survey of general paediatric and neonatal services concurrently in September 2019. The services and workforce were surveyed on a weekday and weekend day to provide an “on the ground” picture of units and staff working in these services.

The GIRFT programme is running a review of neonatology services in England, supported by NHS Specialised Commissioning, aiming to improve quality of care by reducing unwarranted variations. For this study, we were able to expand the scope to be UK-wide. 

The RCPCH workforce team led the general paediatric snapshot survey, Dr Nicola Jay, RCPCH Officer for Workforce Planning and Health Services, was the clinical lead. The GIRFT neonatal team led the neonatal snapshot survey and Dr Eleri Adams was the clinical lead. 

General paediatric snapshot report

In the general paediatric snapshot study, we asked services to complete information about rotas, staffing, and activity levels. We surveyed 192 general paediatric services in the UK and received a response from 124 (65%). The findings outlined in the report, A snapshot of general paediatric services and workforce in the UK, include:

  • An average of 10% of staff were missing on the training rotas on weekdays.
  • A quarter of units had at least one locum present (25.3%).
  • Non-medical staff tended to be more available on the weekday compared to the weekend. For example, 84% of units had a play therapist present on a weekday compared to just 31% on the weekend.
  • Six percent of acute ward beds were occupied by a child admitted due to a mental health problem.

This survey was conducted prior to the COVID-19 pandemic, which we know has impacted on child health services due to redeployment of staff and clinical space. Our findings highlight that paediatric services were overstretched even prior to the pandemic, and must be supported to reset, restore and recover. This may include being protected from adult surge policies in the future.  

Neonatal snapshot report

The neonatal snapshot survey was conducted on one week day and one weekend day in September 2019, with 191 Neonatal Intensive Care Units (NICUs), Local Neonatal Units (LNUs) and Special Care Units (SCUs) asked to submit staffing and activity information. In addition, every individual working on medical rosters on those days was asked to complete detailed information about their shift, as well as their views on safety, staff support and wellbeing.

Among the findings outlined in the report, A snapshot of neonatal services and workforce in the UK, are:  

  • Ten percent of neonatal units had gaps in medical staffing, with 5% of shifts covered by locums. 15% of units had gaps in nursing staff;
  • Weekend medical staffing levels are around two-thirds of weekday levels for all NICUs.
  • Only one-fifth of NICUs and one-tenth of LNUs/SCUs had a psychologist available support families.