THE children’s ward at Dorset County Hospital is at risk in a major overhaul of the county’s healthcare services, the Echo can reveal.

As part of the Dorset Clinical Commissioning Group’s (CCG) Clinical Services Review, it is recommended that children who have serious illnesses or need long-term care would have to go to the east of the county.

There would also be just one special care baby unit- again, in the east.

A document seen by the Echo says ‘experts in paediatric medicine and care are indicating that it is […] not necessary to have large and increasing numbers of inpatient beds for children.’

It is recommended that instead of being admitted to hospital ‘the care of children could be delivered in a different and more effective way.’

And one option is to have a Paediatric Assessment Unit (PAU) for west Dorset, where consultants would be available 16 hours a day.

So if children need more, serious or long-term treatment, they would be sent to the proposed major emergency hospital in east Dorset (Bournemouth or Poole)- and not at the Dorchester hospital.

The plans have been labelled 'unacceptable' with west and south Dorset receiving a 'second-class' health system.

Parents whose children have needed treatment at Dorset County Hospital have spoken of their fears over the plans.

Jodie Wright’s daughter Kalli received a year’s worth of treatment for kidney cancer when she was just 18 months-old.

Kalli, now three, is in remission.

Mrs Wright said: “We had quite a few lengthy stopovers at the Kingfisher Ward (DCH), and we found it really good.

“The staff are brilliant, you couldn’t ask for better nurses and doctors and the care was brilliant as well. The facilities are superb, the indoor and outdoor play areas are great for children who have been cooped up for so long.

“It will have a huge affect on families if Bournemouth is the closest one. It’s an hour away and can even be longer if the traffic is bad. Being close to the family is really important for children when they are kept in isolation; they need that support and that helps them get better.

“I definitely want to see it stay, if Kalli fell ill again I don’t know how I’d cope if I had to go to Bournemouth. The added stress, the added travel, it would have a huge impact on my life if the care was not on my doorstep.”

The Echo learned of the proposals yesterday, just as a top-level meeting was being held.

Dr Karen Kirkham, of Weymouth and Portland, provided a presentation about the review.

When asked about the future of paediatric care at Dorset County Hospital, she said: "We are looking at the possibility of a PAU. We are having a lot of discussions at the moment and no decisions have been made yet.

"PAU will be a unit where children can come in for investigation, assessment by a consultant, and possibly a short stay.

"We haven't made any decisions yet about in-patient beds."

In Dorset there are two children’s wards with 26 inpatient beds at Poole Hospital and 12-17 inpatient beds at Dorset County Hospital.

In 2013/14 there were more than 16,000 unplanned admissions at Poole Hospital and Dorset County Hospital and 40 per cent of these children were admitted for less than 24 hours.

Nationally, says the CCG, there has also been a 28 per cent growth in unplanned admissions in the last 10 years, almost entirely for 24 hours or less and often for conditions such as respiratory tract infections and gastroenteritis.

‘This data indicates that these cases are usually not serious and often just need observation. The increase in numbers does not reflect increasing numbers of sick children as the number of childhood deaths has decreased by 17 per cent between 1999 and 2012.

‘Experts in paediatric medicine and care are indicating that it is therefore not necessary to have large and increasing numbers of inpatient beds for children. Instead of being admitted to hospital the care of children could be delivered in a different and more effective way,’ a statement says.

When approached by the Echo, Dorset County Hospital said it will not agree to any proposals that would ‘disadvantage’ residents.

“The CSR options paper talks about developing a more extensive paediatric assessment unit at DCH.

“We are working with the CCG to ensure our young patients receive safe and effective health care. We want our paediatric service to be sustainable for the future and we would not agree to anything that would disadvantage our population,” a spokesman said.

Patient governor Michel Hooper-Immins, chairman of the Weymouth and Portland Health and Wellbeing Group, said: “If it goes through, I would be appalled that 24-hour care for children is being taken away.

“I’m always worried when things leach to the east of the county, and I think it’s unacceptable that people in south and west Dorset get a second-class health system.

“These consultants do not think it through properly. How about the worry for the families, the journey there for the parents who need to see their seriously ill children?

“What we have got to do is make a big fuss. We need to respond to this consultation, write to our MP and make a big fuss and show them how angry we are. We have got to make sure this does not happen.”

A decision will be made in Spring 2016 following public consultation.

The Echo learned of the proposals as bosses sat down for a top-level meeting this afternoon.

They have agreed all the recommendations they were looking in to.

These are:

A) Agreeing with the out of hospital approach

B) Agreeing with the acute hospital models of care and site specific options

C) Approving the proposal to proceed to consultation

D) Approving the delegation of authority to the Chair and Accountable Officers to make minor amendments to the consultation proposal to address the external assurance feedback

E) Approving the delegation of authority to the Control and Assurance Group to sign off then consultation document

Speaking after the decision, CCG chairman Dr Forbes Watson said: "No decisions have been made at this time. The decision has been made to go to consultation and that will be a robust process and an opportunity for members of the public to be very involved in the process."

A STATEMENT from the CCG says: ‘In response to the need to change, the proposals outline a bold ambition to build on the good services for children that we have in Dorset to deliver even higher quality, safer and more sustainable service to help sick children across the county. 
‘This will see the introduction of a networked approach with paediatric doctors and nurses from across Dorset working closely together to provide community and acute hospital based care. 
‘A significant element of the proposed model for children’s services is about improving the services available closer to people’s home through enhanced GP and primary care services. This would include the introduction of seven day working, which would mean people will have more access to their GPs in the evenings and weekends for medical advice and appropriate care. This is aligned to national plans to deliver improved access to GP services. 
‘Enhanced GP services would be complemented in Dorset by the development of a network of community based ‘hubs’ through which a greater range of services would be provided. This would include services that currently require a visit to an acute hospital including some diagnostics, outpatients and rehabilitation. Consultant paediatricians would deliver appropriate care to patients within the hubs and other dedicated children’s services would also be provided. There would also be an increase in community provision through outreach community nursing teams. 
‘Where children need specialist paediatric assessment or treatment at an acute hospital, the proposals would see the provision of 24/7 consultant delivered care on site at the Major Emergency Hospital in the east of Dorset. This would also include a specialist neo-natal unit for the care of very ill or premature newborn infants. 
‘The details of the proposed future paediatric provision at Dorset County Hospital including inpatients are still being discussed with clinicians to ensure a proposal that will deliver high quality care in a safe and sustainable manner. In identifying the solution the detailed proposal will consider the national guidance, including that from the Royal College of Paediatrics and Child Health and the views of the Wessex Clinical Senate. 
‘This work is ongoing and at this time no decisions have yet been made. 
‘To date, the proposals have suggested that the direction of travel in the west of the county would be in line with national guidance towards the provision of a high quality paediatric assessment unit (PAU) as part of a Dorset-wide network. The PAU would provide consultant delivered on site care for 16 hours a day 7 days a week and offer rapid assessment and access to diagnostic tests.’

Mum and son speak out against changes

SARAH George, from Dorchester, has had two children treated at the Kingfisher Ward. 
Her eldest son, Rian Harvey, 16, has been a patient at the ward for the past two years after being diagnosed with acute myeloid leukaemia. 
Her daughter Maisie also attended the ward after contracting a rare form of meningitis when she was three years-old.
Mrs George, who spoke very highly of the care her children received, said: “All the travelling would be very bad. Not only are children being taken out of their home environment when they are very ill, they’re being moved out of their home town which will be worrying for them. I think it would be counter-productive for their recovery.
“The added pressure for the families will be big, and the financial pressures will be massive. We know the pressure of it from being in DCH, never mind the worry of travelling to the east every time."
Rian, a student at Thomas Hardye School, said: “When I heard about it I was quite angry, they are like a second family to me.
“I have to go in for regular blood checks, and if I had to go to Bournemouth or Poole that would be upsetting and awkward not only for me but for my whole family. 
“When you change doctors and hospitals, everything gets muddled up and confused. It’s ridiculous really that they are thinking of changing it.
“I really don’t want this to happen. Everyone there has stuck by me over the last couple of years and I’d be really upset."