North Central London Paediatric Services

A multi-organisational approach to 2009 compliance across a healthcare community

North Central London Update

At the time the North Central London bid was put forward and accepted, plans were well advanced and about to go to public consultation regarding reconfiguration of paediatric services across the six acute care sites. This process was named Healthy Start Healthy Futures (HSHF) and was run under the auspices of the board of PCTs. The key recommendation was a reduction from six to four inpatient sites for paediatrics, with two hospitals moving to an ambulatory care model with no overnight paediatric beds. In parallel with this, it was planned that neonatal services at one of these trusts would reduce to a Level 1 unit. The Working Time Directive project was closely linked to implementation of HSHF, and it was envisaged that the process of reconfiguration would facilitate collaborative medical models.

However, one trust board took the view that closure of inpatient paediatric beds would threaten the financial viability of the trust, and instead proposed a consultant delivered model of service to maintain inpatient services which was implemented from March 2007. In view of these developments the rest of the HSHF consultation has been suspended. In addition the environment of the NHS has changed rapidly since November 2006. The financial constraints and implications of payment by results has reduced the collaborative working which was previously a strong feature of the paediatric network in North Central London. By contrast, the participating trusts have become more focused on their own internal environment and the financial sustainability of their individual services. The project team and host chief executive discussed the options for the project and it was felt that the environment that would enable the objectives of the original project to be met successfully no longer existed. The project was therefore brought to a close.
Project closure and learning reports have been developed with the project hosts which can be found here>>>

A new model for co-operative service provision is now being developed. Proposals include the piloting of a new model of care for children, based on an integrated healthcare service across primary and secondary care. The service would operate through dedicated children’s healthcare centres delivering both primary and secondary care, based on a polyclinic model. This would be complemented by 24-7 urgent care on the hospital site, delivered through the same provider organisation, using appropriately trained multi-professional primary care practitioners working collaboratively with the secondary care team. The proposed advantages of this model are highlighted, as well as the potential impact on existing service providers.

Click here to access resources produced by North Central London paediatric services in the course of their co-operative solutions pilot project.