01 September 2006
The Healthcare Commission is concerned about the standards of children's services in more than a quarter of casualty and almost half of the outpatients departments in England.
In the first of four reports in the build-up to the publication of its first annual health check on October 12, the watchdog assessed 157 hospitals' progress on child-focused initiatives, such as the 2003 national service framework for children and young people. It concentrated on areas where trusts should have made improvements, such as the introduction of child-friendly environments and the training of staff in the care of children.
It was not limited to paediatric departments but covered all areas where children were treated.
In the report, published on August 31, the commission said outpatient services had the greatest room for improvement, with almost half the trusts rated as weak. The poor ratings were mostly caused by a lack of suitably trained staff, such as children's nurses.
Surgeons and anaesthetists lacked expertise in treating children – 28% of trusts were weak when it came to training in emergency surgery and 22% in elective surgery. No trust scored good or excellent in this category.
It said 28% of trusts were rated as 'weak' in emergency settings. Between 2 million and 2.5 million children are treated in accident and emergency departments each year but the watchdog found that many were not seen in child-specific surroundings.
A&E departments open to all ages can be frightening for young children, the commission said. Inpatient services were much better, with 71% of trusts rated as good or excellent.
Most trusts were meeting minimum standards – 25% received an overall score of excellent or good, while 70% were fair. However, 5% were rated as weak overall.
Anna Walker, the commission's chief executive, said children's health care needs were distinct from those of adults.
'The problem areas seem to be A&E and outpatient services. More skills in dealing with children are needed here. The commission will be monitoring progress, particularly in those trusts where improvement is most needed, to ensure they can move towards meeting best practice as set out in the NSF.'
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