Bristol Children's Hospital cuts number of heart ops after formal warning

A Bristol hospital where concerns were raised after children died after heart surgery has received a formal warning from health regulators.

The Care Quality Commission found that staffing on ward 32 of Bristol Children's Hospital was inadequate and felt this had a "major impact" on the care and welfare of patients.

As previously reported in The Post parents of children who died at the hospital this year following planned heart surgery raised concerns about care and staffing on ward 32.

Seven-year-old Luke Jenkins died weeks after four-year-old Sean Turner. Both had cardiac operations at the hospital.

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Their parents had also raised concerns about high dependency care at Bristol Children's Hospital, which was noted by inspectors.

The Care Quality Commission visited the city centre hospital on September 5 after receiving concerns from families.

They found that the trust was not "reducing the risk of children receiving unsafe and inappropriate care, treatment and support"

Inspectors said this was due to high dependency care being delivered on the ward "without adequate staffing levels over a sustained period of time". They said there were established nurse staffing levels on the ward but that these did not meet the high dependency of some of the children being cared for on ward 32.

Medical and nursing staff also told the inspectors that staffing levels meant sometimes observational checks were not being done on the ward and that "because of the overstretched nature of ward 32 there was not enough time for staff to communicate with families".

University Hospitals Bristol NHS Foundation Trust (UHBristol), which runs the hospital, has now reduced the number of heart operations at the hospital and added high dependency beds to the paediatric intensive care unit. In response to the report the hospital trust is bringing forward plans for a children's high dependency unit and is recruiting more specialist nurses.

A meeting was held this week by NHS South of England, along with the trust, Monitor, Care Quality Commission and NHS commissioners to consider the actions taken by the hospital to ensure that the safety issues are being addressed. They considered them appropriate and said their impact would be closely monitored. 

Ian Biggs, deputy director of CQC in the South said: "Everyone seems to agree that there should have been more staff on duty looking after some very frail children. 

"All the parents we spoke with on Ward 32 told us that their child had received good treatment, support and care, even if the staff were very busy.

 "Doctors and nurses told us that the current staffing levels were having an impact on the care and service being provided, with checks missed or reduced at times, and not enough time to communicate with families.

"The trust themselves have acknowledged that their system of providing high dependency care was not sustainable.   But having identified the risks of providing high dependency care on a general ward, they had not taken effective steps to ensure they reduced the risks to patients.  

"We found that on a number of shifts, staffing levels on Ward 32 fell below these inadequate levels, and to make matters worse, some staff did not have the appropriate experience to care for patients with high dependency needs."

Chief executive Robert Woolley said: "I was very disappointed by the CQC's findings following its inspection of one of our wards in the Bristol Royal Hospital for Children, the paediatric cardiac ward.  No family should leave the Bristol Royal Hospital for Children believing that we did not provide the best care possible for their child. I am deeply concerned that some families believe that we have let them down and will continue to ensure that we address their concerns and bring forward our plans to develop a high dependency unit."