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

The changes are summarised above these FAQs.  In detail, they are:

• Barnet Hospital paediatric emergency department and inpatient unit has reopened and will include child and adolescent mental health services (CAMHS) crisis support
• The Whittington paediatric emergency department and inpatient unit remains open and has expanded to meet forecast demand.
• North Middlesex University Hospital paediatric emergency department remains open with additional capacity. Inpatient services continue.
• University College London Hospitals’ (UCLH) specialist inpatient and day-case services, including cancer haemato-oncology and complex adolescents, will remain open. The UCLH children and young people’s emergency department will remain temporarily closed over winter.
• Royal Free Hospital’s children and young people’s emergency department will temporarily close as will its paediatric inpatient beds.
• To ensure maintenance of access to elective services, GOSH will provide 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, will inform parents and carers of children and young people about these temporary changes and encourage 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 arrives at UCLH or Royal Free Hospital, they will be assessed by specialist nursing teams with experience of children and young people’s health. They may be directed to an alternative local hospital or other services depending on their condition and the treatment needed. If a child requires an emergency admission they would be transferred to another local hospital.

Doctors in North Central London led by Dr Chris Streather, Medical Director and Paediatrician at the Royal Free Hospital worked together to develop recommendations for the safe delivery of children and young people’s hospital services in North Central London throughout autumn and winter.

The recommendations were considered and supported by the North Central London Clinical Advisory Group, the London Clinical Advisory Group and North Central London Gold, comprising chief executive level representation from health partners across north central London.

The proposals have been 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.

The changes relate to paediatric emergency and inpatient services, but there will also be some minor changes to GP services (primary care), community services and child and adolescent mental health services (CAMHS) to ensure a more joined-up and consistent approach to service delivery across NCL.

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 will be evaluated on an ongoing basis to make sure we are providing safe and high quality care.