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Friday, 5 January, 2001, 00:13 GMT
Child burns victims failed
Performing burns surgery
Many specialists burns units lack facilities for children
Scores of children who are victims of burns are being left disfigured for life, or even dying unnecessarily because hospitals are failing them, reports Newsnight's Matthew Hill.

Concern has grown in the medical profession about the way in which supposed centres of excellence in the treatment of burns have neither the specialist staff, or facilities to provide the best possible care.

A task force of burns experts, the first of its kind, is about to make wide-ranging recommendations which they hope the government will take up to stop even more young lives being ruined.

Trudy and Tony Vaughan experienced first hand just how poor the current service can be.

Their one-year-old daughter, Sigourney went into hospital two years ago with apparently manageable burns, but never returned home.

Sigourney suffered 13% burns after she was splashed with boiling water from a kettle.

Skin grafts

The Frenchay Hospital in Bristol told her parents she would need skin grafts, but her condition was not life-threatening.

Andrew Burd was the only consultant burns surgeon at Frenchay Hospital at the time.

He was not on duty that night and so Sigourney was examined by less senior staff.
Sigourney Vaughan
Sigourney Vaughan was scalded with water from a kettle

Mr Burd had been campaigning vociferously for more specialist staff for some time before Sigourney's death.

He had warned the trust in writing that patients' lives were at risk.

He said: "We did have some situations where junior staff thought the patient was OK and they weren't and we did have one or two near deaths and I was concerned about those."

Sigourney was moved into the adult intensive care unit as her condition deteriorated. Frenchay, like most other hospitals with burns units around the country, lacks a specialist intensive care facility for children.

In the adult unit the staff there were not trained to deal with children needing complex care.

There was a dispute between intensive care consultants and Mr Burd about whether she needed to be transferred to a children's unit.

In the end Sigourney was not moved to a children's hospital for paediatric intensive care for a week.

Mr Burd said: "This child remained in intensive care at Frenchay for far too long really.
Burns surgeon Andrew Burd
Burns surgeon Andrew Burd: Wanted more staff

"Because I've seen thousands of burns children I knew this was not a typical case of a burn child having a burn related sort of problem. This was something else."

Mr Burd was suspended soon after Sigourney's death, the main grounds were dereliction of duty.

But an inquiry commissioned by the hospital into the circumstances surrounding Sigourney's death makes only mild criticism of Mr Burd.

The report says the cause of Signourney's death was probably avoidable errors made by people working on a unit that was not properly staffed.

Second World War

Burns units were first set up in the UK to deal with the horrific injuries suffered by fighter pilots in the Second World War.

Most were based near to military bases, often far from major cities, and more than half a century on no systematic re-organisation of the service has ever taken place.

Mr Burd estimates the poor quality offered by these units is responsible for the unnecessary death of up to 10 children a year, with up to another 40 unnecessarily experiencing serious suffering.

He said: "If those patients had been treated in a unit with a high turnover, with a lot of concentration of expertise, those patients could have had a very different quality of life after their burn."

The first review of its kind to be published early next year will point out the inadequacies of the present system.

It will recommend complete reorganisation into three levels of care:

  • It will allow some smaller hospitals with casualty units to assess minor burns
  • If the patient needs to be admitted they will have to be seen by a consultant who has burns training
  • Just a handful of specialist centres with a 24 hour dedicated burns teams, and an intensive care facility, will deal with the smaller number of very severe burns
A Newsnight survey of the 16 burns centres in the UK shows the present set up is a long way from the reviews recommendations.

Only one centre - Manchester - has both paediatric intensive care and a specialist burns team available 24 hours a day - but it has just been announced that the unit is closing.

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20 Dec 00 | Northern Ireland
Burns surgeon to stay
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