Public Release: 

More children admitted to intensive care but with lower staffing ratios

University of Leeds

More children than ever are being admitted to intensive care units in England and Wales but there are fewer staff per bed available to cope with the increase, according to a new report published jointly by the University of Leeds and University of Leicester.

The Paediatric Intensive Care Audit Network (PICANet) report showed that there was a 15% increase in admissions over a 10-year period between 2004 and 2013, but this included an increase of 4% that was not due to changes in the childhood population.

At the same time, staffing levels have increased by 36% but this increase has not matched the 40% increase in paediatric intensive care beds.

PICANet is commissioned by the Healthcare Quality Improvement Partnership (HQIP), a multi-agency organisation established in April 2008 to promote quality in healthcare, as part of the National Clinical Audit Programme and is run jointly by the University of Leeds and the University of Leicester.

PICANet has collected data on all admissions to paediatric intensive care in England and Wales since 2002 and has expanded to include Scotland, Northern Ireland and the Republic of Ireland. In this special 10-year report, they looked at details of nearly 134,000 admissions to English and Welsh units of children aged between 0 and 15 years over the period 2004 to 2013.

Professor Liz Draper from the University of Leicester said: "Paediatric intensive care units continue to have difficulty achieving the Paediatric Intensive Care Society standards for nursing care.

"Over time, the complexity of care that some of these children have required has increased, yet staffing levels have not risen to meet this need. A large number of cases require more than one nurse to attend to a child in a paediatric intensive care bed, so there is still great pressure on these nursing staff to deliver under often very difficult conditions."

Dr Roger Parslow, from the School of Medicine at the University of Leeds, added: "With this long-term dataset, we are able to examine trends in outcomes, interventions and patient profiles. This enables effective planning for the future as well as providing the kind of data doctors and researchers need to set up clinical trials to improve the treatments that children receive in paediatric intensive care."

Dr Michael Marsh, representing the independent PICANet Steering Group, commented: "The last twenty years has brought phenomenal improvements in the outcomes of critically ill children in England and Wales. This is in part due to systematic organisation of paediatric intensive care services and improvements in the quality of care provided. It would be a tragedy to see these improvements compromised by failures to attend to proper staffing of units."

Professor Draper added: "Over the 10 years of PICANet the situation has not improved and issues of staff retention and training as well as the adequacy of funding of the service need investigation."

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The eleventh annual report from PICANet on activity and outcomes in paediatric intensive care services in the UK and Ireland, including a series of special articles on trends over the last decade, is available to download free here: http://www.picanet.org.uk.

Further information:

Contact: Ben Jones, University of Leeds Communications & Press Office: Tel +44 (0)113 34 38059, email B.P.Jones@leeds.ac.uk

Contact: Ather Mirza, University of Leicester Press Office: Tel +44 (0)116 252 3335, email: pressoffice@le.ac.uk

A copy of the report is available from either press office.

Notes to Editors:

1. PICANet has been collecting data on all admissions to paediatric intensive care in England and Wales since 2002 and has expanded to include Scotland, Northern Ireland and the Republic of Ireland. It currently holds data on over 197,000 admissions. The information held on the PICANet database has been used by the Department of Health, strategic health authorities, commissioners, clinical audit teams, researchers and individual institutions to improve the delivery of paediatric intensive care.

2. PICANet is commissioned through the HQIP and the National Clinical Audit Programme* and also administered by the Welsh Health Specialised Services Committee; NHS Lothian/National Service Division NHS Scotland; the Royal Belfast Hospital for Sick Children; National Office of Clinical Audit Ireland (NOCA) and HCA International.

3. About HQIP, the National Clinical Audit Programme and how it is funded

The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP commissions and manages the National Clinical Audit and patients outcomes Programme, comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The programme is funded by NHS England, the Welsh Government and, with some individual audits, also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands. http://www.hqip.org.uk

4. The University of Leeds is one of the largest higher education institutions in the UK and a leading research powerhouse. It is a member of the Russell Group of research-intensive universities. http://www.leeds.ac.uk

5. The University of Leicester is a leading UK University committed to international excellence through the creation of world changing research and high quality, inspirational teaching. Leicester is consistently one of the most socially inclusive of the UK's top 20 universities with a long-standing commitment to providing fairer and equal access to higher education. Leicester is a three-time winner of the Queen's Anniversary Prize for Higher and Further Education and is the only University to win seven consecutive awards from the Times Higher. Leicester is ranked as a top 20 UK university and among the top two-per cent in the world. http://www2.le.ac.uk/about/facts

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