Each year NHS services see an increase in patient activity during the winter. Combined with the unprecedented pressures from the COVID-19 pandemic, we reviewed children and young people’s NHS services to ensure they could be delivered safely. We made some temporary changes to ensure our services continued to meet the needs of children and young people and could be delivered safely to protect patients and staff.

• Barnet Hospital paediatric emergency department and inpatient unit  reopened and services include child and adolescent mental health services (CAMHS) crisis support.
• The Whittington paediatric emergency department and inpatient unit remained open and expanded during the temporary changes to meet forecast demand.
• North Middlesex University Hospital paediatric emergency department remains open with additional capacity. Inpatient services continue.
• University College Hospitals’ (UCH) specialist inpatient and day-case services, including cancer haemato-oncology and complex adolescents, remained open. The UCLH children and young people’s A&E and general inpatient wards temporarily closed over winter and will reopen at 9am on Thursday 8 April.
• Royal Free Hospital’s children and young people’s A&E and general inpatient temporarily closed during the winter and will reopen at 9am on Monday 12 April.
• To ensure maintenance of access to elective services, GOSH provided more room for urgent elective inpatient and some – but not all – day surgery.

Parents should call NHS 111 or go to https://111.nhs.uk, before leaving home, so we can direct you to the nearest Children’s emergency department or the most appropriate place for care. 

A campaign across north central London, using social media and newspaper advertising, informed parents and carers of children and young people about these temporary changes and encouraged them to call NHS 111 or go online to https://111.nhs.uk, to find the most appropriate and nearest services.

The safety of children and young people is our priority. If a child arrived at UCH or Royal Free Hospital, they were assessed by specialist nursing teams with experience of children and young people’s health. They may have been directed to an alternative local hospital or other services depending on their condition and the treatment needed. If a child required an emergency admission they would be transferred to another local hospital.

The proposals were agreed by the senior and clinical leadership of NCL and NHS England and Improvement London.

The review gathered information from emergency department attendances, inpatient admissions, population density, deprivation levels and transport links across North Central London.

It also took advice from people who work with local children and young people, such as school nursing services, special educational needs (SEND) groups and child and adolescent mental health services (CAMHS).

The review focused on four key areas:

• Hospital services including emergency and planned care
• Community and primary care
• Child and adolescent mental health services (CAMHS)
• Staff and workforce.

The review agreed these principles:

• Ensure that all children and young people can access high quality care.
• Population density, deprivation levels and transport links need to be a major consideration as to how and where services are delivered.
• Ensure staffing levels, experience and skill-mix will continue to deliver exceptional quality of care.
• No reduction in inpatient beds.
• Children and young people’s hospital beds must be protected from any adult Coronavirus wave, to support the winter surge in paediatrics.
• Enable better clinical cross-site working to support our colleagues in services for adults to respond to a second surge.

These were temporary changes needed to ensure our children and young people’s services could be delivered safely during the autumn and winter period, and during a pandemic. Any future proposals to make permanent changes to services would require a full public consultation.

No. These temporary changes are being implemented to ensure our paediatric services can be delivered safely during the coming autumn and winter period, during the pandemic.

These temporary changes were monitored on an ongoing basis to make sure we provided safe and high quality care.

We are keen to learn from these temporary changes, understand what worked well and what could be improved.  A number of surveys and other feedback opportunities have been designed to gather feedback from those affected by the changes. Find out more.