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June 16, 2006 12:38 PM

A public consultation was launched today (Friday, 16th June) around proposals to ensure the continued delivery of paediatric (children's) services in Inverclyde.

The proposals centre on developing and improving outpatient and day case care for children within Inverclyde Royal Hospital (IRH) and enhancing services delivered in local communities.There are also plans to create a dedicated Inverclyde Children's Centre, which would bring together a wide range of community and specialist services for children.

The proposals would guarantee long-term retention of all local paediatric services in Inverclyde with a single exception: IRH's Acute Assessment Unit (where children displaying a range of symptoms can be monitored and moved to specialist care if required).Under the proposals, the Unit – which on average currently sees less than one child a day - would be relocated alongside similar services at the Royal Alexandria Hospital (RAH) in Paisley.The combined unit at RAH would offer 24 hour, 7-day-a-week care as opposed to the Monday to Friday, 9 am to 5 pm service now offered at IRH.

Since NHS Greater Glasgow and Clyde took on responsibility for healthcare in Inverclyde, following the dissolution of NHS Argyll and Clyde in April 2006, medical and planning staff have been carefully assessing options for future provision of children's care at IRH and in local communities.

NHS Argyll and Clyde had been facing the consequences of national changes to doctors and consultant's terms and conditions which limited the numbers of hours they could work.This had a knock-on effect of making it much more difficult to provide sustainable 24-hour cover for services.

Another factor was the relatively low throughput of young patients to Inverclyde's Acute Assessment Unit which in turn meant staff found it difficult to keep their skills up to scratch and complete their required professional training.A number of Royal Colleges had indicated that they were considering withdrawing training accreditation from IRH if children's services weren't reorganised.

It has proven difficult to recruit and retain staff at the Acute Assessment Unit in particular given these problems and the hospital has been forced to rely on locums.

Dr Brian Cowan, Medical Director of NHS Greater Glasgow and Clyde, said:

"We've taken a fresh view of the situation in Inverclyde.It is clear that action has to be taken soon if we are to secure the ongoing provision of local children's services.

"The proposals we are taking out to consultation today are designed to ensure continuing delivery of Children's Services in Inverclyde and fit in with our overall objective of retaining sustainable, safe and affordable clinical care locally wherever possible."

Dr Graham Stewart, Associate Clinical Director of Clyde Children's Services added:"Moving the Acute Assessment Unit would affect on average less than one child a day, the majority of whom arrive at the IRH in an ambulance.Most go home after a period of observation and a very few, who give signs of something more serious being wrong with them, are currently transported to the Royal Alexandria Hospital for specialist paediatric care.

"By locating the unit in Paisley, we think the impact will be relatively small and, in fact, it would mean that those children who do develop a problem needing specialist attention would not have to be moved again other than in exceptional circumstances.

"It is our aim, as we develop our proposals through this consultation, to find ways of ensuring that a significant proportion of even this small number of young patients can be offered local care options.

"The pay-off from the proposals would be that we could reconfigure children's services – A & E, day surgery, clinics and investigation services, as well as community-based services – and put in more staffing resources and other investment that would strengthen and sustain them to meet the future needs of Inverclyde's children."

The proposals and the consultation have received strong support from clinical staff based in Inverclyde.

Dr Jim Ward, Lead GP for Inverclyde said:"In my view the proposals would result in improvements to the management of children's health by local community-based teams.These days fewer children who fall ill ever need hospitalisation.It's much more effective to provide outreach services to children with complex health and social care needs in their own neighbourhood.

"Local care providers are in a good position to anticipate when children will need help and this is much more effective than having staff sitting in a hospital unit waiting for children to become unwell and be brought to them."

Sister Frankie McLaughlin, Clinical Nurse Manager of Accident & Emergency Services, at Inverclyde Royal Hospital said:"These proposals would provide a more joined-up, seamless service for children and their families and enable us to deliver more care, closer to home.For example, many children currently attend A&E for relatively simple follow-up procedures that, in the future, could be carried out in local health centres and clinics so that children don't have to travel to hospital."

Dr Brian Kelly, Consultant Paediatrician at Inverclyde Royal Hospital said:

"There is a compelling need to change the way our existing children's services are organised as the current arrangements do not make best use of our existing skills and resources.If we don't take action now then we risk losing experienced and committed staff and will find it difficult to attract the new staff we need to develop and improve services for local children."

The proposals for Inverclyde's Children's Services include:

  • Refurbishing existing ward accommodation to create a dedicated Inverclyde Children's Centre purpose-designed to deliver the new service arrangements
  • Continuing access to the A & E unit for children supported by additional nursing staff who would organise safe transfer to specialist care as required
  • Continuing delivery of day surgery services for children
  • An expanded Community Nursing team
  • Enhanced home nursing services for children with a range of conditions
  • Expanded range of outpatient/day children's services including paediatric consultant clinics, nurse-led clinics and planned medical investigation

The consultation will go on until Friday 28th July 2006



1. Paediatric services based at Inverclyde Royal Hospital (IRH) and in local communities provide care for young people under 16 years of age.

2. The former NHS Argyll and Clyde conducted a three-year review of acute services, including paediatric care.Interim service arrangements were put in place at IRH in 2003.

3. The current service model is divided into two components:

  • Emergency Care – which comprises the A&E service and an Acute Assessment Unit
  • Planned Care – which comprises pre-arranged (elective) day surgery, clinics and planned investigation as well as community based services, including services delivered in Port Glasgow, Cowal and Bute.

4. The proposals would see all of the services above retained in Inverclyde and/or enhanced with one exception – IRH's Acute Assessment Unit.

5. The Acute Assessment Unit admits children suffering symptoms like breathing problems, rashes, sever diarrhoea and vomiting.They are kept under observation until it is possible to determine if there is a serious problem.The majority of children in these circumstances go home alter a period of observation ranging between four and twelve hours.A small number may be transferred to the Royal Alexandra Hospital (RAH) in Paisley if doctors decide inpatient admission is required.A still smaller number on rare occasions may be transferred to regional specialist services based at the Royal Hospital for Sick Children in Glasgow.

6. Last year, the Acute Assessment Unit dealt with 291 children – an average of less than one child per day.Many are referred by their GP.The unit is only open between 9 am and 5 pm Monday to Friday.Outwith these hours children are referred direct to the RAH in Paisley.It is also the case that GPs are tending to bypass the unit and send children direct to the RAH if they have judged that there is a problem which requires their hospitalisation.

7. The consultation was launched on 16th June and will carry on to 28th July 2006 – although there may be scope to extend this period if there is demand to do so from stakeholders.

8. Leaflets and consultation papers will be distributed widely to community, patient representative groups and key stakeholders.Arrangements are being made to send a letter to the parents of all school children in Inverclyde to draw their attention to the consultation.Leaflets will also be distributed to GP surgeries, pharmacies, hospital waiting areas and local libraries.

9. Anyone who wants a copy of the leaflet for full consultation paper can either download it from or call 0141 201 4908 during office hours.

10. An evening workshop event is to be held at the Tontine Hotel in Greenock on Tuesday 18th July 2006.This will give members of the public an opportunity to hear directly from the clinical staff responsible for drawing up the proposals and to ask questions, debate the issues and put forward their points of view in workshops sessions.People wishing to take part in the event must register in advance by telephoning 0141 201 4908 during office hours.

11. If the event proves to be oversubscribed, a second event will be organised at a date thereafter.

12. Anyone who wishes to make a submission to the consultation can do so by writing to:

John Hamilton
Head of Board Administration
NHS Greater Glasgow and Clyde
Dalian House
350 St Vincent Street
Glasgow G3 8YZ

Or e-mailing:

[email protected]

For further information contact the NHS Greater Glasgow and Clyde Press Office on 0141 201 4429 (24 hours).

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Last Updated: 11 November 2021