Birmingham Children's Hospital battles back to good health after criticism
A year after a highly critical Healthcare Commission report, Birmingham Children’s Hospital chief executive Sarah Jane Marsh talks to Health Correspondent Alison Dayani about how she has addressed the issues and ambitious plans for the future
A year on from a damning investigation into waiting lists, bed shortages and delays at Birmingham Children’s Hospital, chief executive Sarah Jane Marsh said the trust is far from dragging its heels in making improvements.
The latest move is a £7 million investment to transform and expand the paediatric intensive care unit to create 11 more much-needed beds, taking the total up to 31, plus 77 extra nurses, so more patients can be admitted.
That will be followed with improvements to operating theatres to cater for more cardiac patients – a department that was under pressure for cancelling too many heart operations and being forced to send children on long waiting lists as far away as Leicester for surgery.
It was a baptism of fire for Miss Marsh, aged 32, when she took over at the helm of one of the country’s largest children’s hospitals a year ago.
It was when the foundation trust faced heavy criticism in a damning report for turning 70 sick children away a month because it did not have enough beds. Delays in coping with high numbers of patients, and a lack of training and management planning were also highlighted.
But Miss Marsh said everyone from executives to medical staff have pulled together to modernise out-of-date systems and face problems head on.
“More beds and theatre expansions are just two big things we felt were a priority this year,” said Ms Marsh, who is engaged to 52-year-old chief executive of the NHS, David Nicholson.
“There were cardiac issues over the waiting list and we are starting to do more heart surgery as the demand for this service has grown.
“There are only about 12 places in the country doing children’s heart surgery and there is currently a national review to reduce this to big centres. We are bidding to have one of them here.”
The Healthcare Commission report noted that an increase in general surgical workload had put pressure on the entire system. In April, 2008, the average bed occupancy at the hospital was 98 per cent and, for 15 days in that month, 99 per cent or higher.
The additional beds should help to address that, but this is also being supported by new schemes that reduce admissions, like specialist surgeons going out to regional hospitals such as Wolverhampton to Walsall one day a week to carry out procedures.
“Until the past 12 months, we were operating traditionally – treat a patient and when they are better, they go home,” added Miss Marsh.
“But we have got a lot more sophisticated around that. We have to think whether all the patients here need to be in this hospital or could they be recovering at other ones.
“Some patients need to stay in hospital two weeks after an operation but they don’t need the specialist treatment available at this hospital, so if we get them back to their local hospital, we can then admit a child in a more serious condition.
“Years ago, when children needed surgery, they would go into a standard hospital where a doctor could operate on an adult or a child, but as those doctors retire, younger doctors have only been trained solely in adult operations, so they can not do it any more.”
Another welcome initiative has been the successful Paediatric Retrieval Unit, first piloted in London. It means when a child needs critical care, a highly trained team from intensive care goes out to the local hospital where the young patient is being treated and cares for them until they have stabilised enough to be transferred to Birmingham for lifesaving treatment.
Medical director Vin Diwakar, who is also a consultant paediatrician, said planning ahead for what type of treatment the hospital will provide in the future is central to current improvements.
