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Changes to the Children’s Inpatient Services at St John’s Hospital

To ensure patient safety, NHS Lothian has taken the difficult decision to make changes to the children’s inpatient services in St John’s Hospital.

Patients will not be admitted to the children’s inpatient ward at the Livingston hospital, from Friday 7 July 2017.

The children’s ward will continue to operate as an assessment and programmed investigation unit from Monday to Friday between the hours of 8am and 8pm.

Parents are not being asked do to anything differently. Most of the children, who currently attend the unit, will continue to be cared for as normal. They will either be referred by their GP for an urgent medical opinion or attend with a pre-arranged appointment for treatment, assessment, tests or minor day surgery.

Children will still be assessed and treated in the Emergency Department at St John’s Hospital at night and weekends. A paediatric consultant will be available on-call 24/7.

If a child needs to be admitted to hospital a transfer to the Royal Hospital for Sick Children, Edinburgh will be arranged.

Maternity and neonatal services at the hospital are unaffected.

The decision to change the opening hours has been made as a result of ongoing staffing and recruitment issues which mean there are not enough doctors available to cover overnight and weekends.

Over the past five years NHS Lothian has invested heavily in efforts to ensure safe staffing levels could be maintained on the ward.
Despite national and international recruitment campaigns and a comprehensive independent review by the Royal College of Paediatrics and Child Health (RCPCH), it has not been possible to fill the key medical and specialist nursing posts required to provide a safe, reliable and sustainable workforce model.

Jacquie Campbell, Chief Officer of Acute Services, NHS Lothian, said: “The safety of our patients must be our top priority and this is a difficult and deeply frustrating decision to have to make.

“I would again emphasise our on-going commitment to St John’s Hospital and the children’s ward. This has been demonstrated through the significant investment in recruitment over the years and in the work that went into the RCPCH review.

“We have relied on our dedicated staff from St John’s and across Lothian to work additional hours to provide these important services. Despite our best efforts we have been unable to reliably secure the levels of staffing required overnight and at weekends to guarantee a safe service.

“If we don’t make changes now to the operating hours of the children’s ward, we run the risk of having to make an unplanned closure at a few hours notice, which would lead to the sudden diversion of patients. This reduction in opening hours is the safest option for children in West Lothian.

“We are committed to reinstating the full service as soon as possible after the summer and will be working with the Chief Medical Officer, Scottish Government and the Royal College of Paediatrics and Child Health to review the steps we have taken and to identify what else can be done to guarantee safe, sustainable staffing for this service.”

NHS Lothian is working closely with the Scottish Ambulance Service, NHS 24, local GPs and neighbouring health boards to ensure the provision of a safe and reliable service.

Extensive public awareness activity is also being planned to ensure that families in West Lothian are aware of the arrangements.


Notes to editors
Around 3000 children attend the children’s ward at St John’s Hospital each year, around one third of these children require to be admitted to hospital.

In June 2016 the NHS Lothian Board agreed to recruit eight additional paediatric consultants to support services within St John’s and the Royal Hospital for Sick Children, following a comprehensive review by the Royal College of Paediatrics and Child Health. A total of five additional consultants have been appointed as a result of an extensive recruitment campaign.

In order to provide a 24 hour, seven-day-a-week service in the children’s ward and maternity unit, including the special care baby unit, the following level of out-of-hours paediatric staffing is required:

  • One junior doctor who is resident at the hospital over night
  • One experienced doctor or consultant who is resident at the hospital over night
  • An on-call consultant who can attend the hospital at short notice to provide a second pair of experienced hands.