Workforce pressures this winter - supporting paediatrics in local settings 

We will continue to call on national governments to support paediatrics and child health this winter. Some of you may wish to raise these issues in your local settings and may find the points below useful. We have also pulled together a range of resources to support you and colleagues on the ground.

Thank you to everyone working across paediatrics for your colossal and continuous hard work to support children and young people currently and during the past two years.

We are in no doubt that we are set for a bumpy ride through to next spring, and as a College we are working with senior partners across the UK to amplify concerns from our members about the pressures so many of you are facing and to advocate for the needs of children, young people and their families.

Our calls to Governments are of course national by nature and overarching across paediatrics. We fully recognise that every country across the UK, the different health boards and trusts, the paediatric and emergency departments will be seeing patients presenting with a variety of concerns and potential complexities. We appreciate you will know far more about your own local situation and therefore, we know in parallel to our national advocacy you may wish to raise concerns on the ground that reflect your local environment.

The information presented here is designed to support you in discussions with your trust, health board or local system representatives. 

Our national facing calls to governments across the UK

As you are only too aware, the UK health system is facing substantial pressures. We are seeing more children and young people presenting at emergency departments with respiratory infections, acute mental health need, and with increasingly complex health needs. This is set against the backdrop of rising waiting times and an ever-increasing backlog of routine and elective work. Of course, children and young people from socially vulnerable backgrounds continue to fall at the sharp end of this pandemic.

Across the board – these issues are impacting services and, of course, the health and wellbeing of paediatricians and the allied clinical professionals in the team.

We are calling on governments across the UK to take action now, and in the long term, to:  

  • Support the paediatric and child health workforce by implementing a fully costed and evidenced-based national recruitment, retention and workforce plan. This should include investment in staff wellbeing and create inclusive and compassionate workplaces.
  • Introduce a sustainable, multi-year settlement for the NHS and ensure that children and young people are not forgotten when strategic decisions about funding and service provision are made. This includes calling for a CYP lead in every integrated care system (ICS) in England, and to be in place in health boards and trusts across the devolved nations.
  • Introduce a clear and fully funded cross-departmental strategy to address health inequalities with measurable goals and resourcing for collecting data to support these.

Support for you and colleagues

Over the last two years we have brought together a number of tools we hope will support you and colleagues on the ground, including your own wellbeing.

It is so important to take care of yourself as well as your patients. College members have written blogs on wellbeing and provided links to support services

Our winter pressures guidance and case studies help you make a compelling and evidence-based case for children's healthcare when services are under immense pressure.

The Association of Paediatric Emergency Medicine is due to host a platform to share best practice, innovation and other resources with paediatric emergency medicine colleagues during this period.  As this progresses we will update members through our communications.

Our webinar on RSV and other respiratory infections, 'Keeping patients safe and pathways open’, recorded in late June 2021, urges service planners and clinicians to consider moving away from COVID pathways and, in collaboration with IPC teams, nurses and operation managers, to develop clinical pathways and contingencies based on local risk assessments.

NHS England and Health Education Improvement, alongside the Paediatric Critical Care Society, have created a programme to support respiratory surge in children. This aims to support the cross-skilling of the NHS workforce to manage existing demand, potential future spikes of respiratory illnesses including RSV, and in the longer term, increasing paediatric acuity and demand in children.

Our bronchiolitis guidance helps support planning in partnership with local infection prevention control teams and is in continuous review.

The General Medical Council’s position still stands that when concerns are raised, the factors relevant to the environment in which the professional is working will always be considered on the specific facts of the case.

NHS England has published some practical guidance, Winter workforce preparedness, for line managers on the holistic approach they are taking to ensure the workforce is well supported and services are as resilient as possible. [added 15 December 2021]

As the country looks to the future of child and young people services and provision both locally and nationally, we must truly learn the lessons of the pandemic so that none of us has to manage through a winter like this again. We will continue speaking to national Governments and providing you with support to help you raise concerns regarding services locally.