West Midlands Health trust criticised over baby care

By Michele Paduano
Health correspondent, BBC Midlands Today

Aiden Hollis had a 7mm hole in his heart

Emergency and neonatal intensive care at a West Midlands NHS trust has been criticised by the Royal College of Paediatrics and Child Health.

An investigation began after the death of Sian Jones, 15, who died of peritonitis after staff at Birmingham's Heartlands Hospital failed to spot it.

There were two other unexplained deaths and a number of serious incidents involving children from 2007 to 2009.

A freedom of information request by the BBC led to the report becoming public.

The request for the report followed the story of Aiden Hollis, born on 19 November 2009 at Good Hope Hospital in Sutton Coldfield - part of the same trust as Heartlands - and taken back to accident and emergency on Christmas Eve after suffering poor breathing and feeding problems.

Four or five years ago, we recognised there was a problem, particularly with space Dr Mike Watkinson

He was discharged despite having a hole in his heart. This was eventually discovered when he was taken to Birmingham Children's Hospital in January where he underwent urgent heart surgery.

His mother, Hannah Roydes, made a complaint to the Heart of England Hospital Trust, which looks after Heartlands and Good Hope hospitals, which was upheld.

The report criticised emergency care at both hospitals.

The paediatric assessment units were described as not fit for purpose.

Experts also had worries about the time it took for a child admitted as an emergency to get a diagnosis.

The report said there were too many layers and too few people able to make clinical decisions.

A sick child could pass through up to six people, it said.

Heart of England NHS Trust chief executive Mark Goldman talks to Michele Paduano about the report

The report also said emergency care was highly unsatisfactory and needed urgent attention.

At Sutton Coldfield, the report said there were not enough nurses and that a radical redesign was required in both paediatric assessment units.

The report also said the new born intensive care service at Heartlands Hospital was stretched to the limit.

When Heartlands Hospital took over Good Hope Hospital, in 2007, its baby care unit was scrapped, but there were no extra cots created at Heartlands.

The high dependency unit was found to be running at 177% capacity - almost twice as many babies were being treated than should be.

'Considerable expansion'

The college has insisted that considerable expansion or a complete new service is the only way forward.

Heart of England Trust said that it had expanded the high dependency unit, creating three more high dependency and five special care cots.

A consultant and 11 extra nurses had been employed to cope with the workload, it said.

Clinical director for neonatal care Dr Mike Watkinson said: "Our survival rates are increasing.

"Our 20 to 28-week babies, when you take out all the deprivation factors, are as good as anybody else's.

"Our activity has really increased over the past 10 years.

"Four or five years ago, we recognised there was a problem, particularly with space."

One service

The trust's chief executive Dr Mark Goldman said he had asked for the report after realising that there was a problem.

He accepted that taking over Good Hope Hospital had caused the wider trust considerable problems.

He said that the trust was working to overcome the "silo working mentality" and create one service across both hospitals.

"Moving forward, the trust's paediatric and neonatal services now have a larger skilled team, led by a new group medical director and clinical director, with clearer lines of responsibility and a refreshed set of goals."