Emergency Paediatric Service Review

Training Recommendations

In August 2013 a Royal College of Paediatrics and Child Health review of paediatric emergency care at WAHT was undertaken. The recommendations of the review on staffing skill level and training focussed on setting the expected level of achievement of the following:

  • APLS course (Advanced Paediatric Life Support) – provides the participant with the skills necessary to lead a paediatric life support interventions.
  • PILS course (Paediatric Immediate Life Support)–provides the participant with the skills necessary to support paediatric life support interventions. PLS (Paediatric Life Support) courses provide training at a level between PILS and APLS.
  • Safeguarding Level 3
  • Multi-agency Safeguarding Training
  • Paediatric Resuscitation

This paper sets out the degree to which these recommendations have been achieved, and identifies the need for specific additional training.

1. Summary of Resource Requirement

Additional funding totalling £4772.50 is sought to ensure that both nursing and medical staff are PILS/PLS/APLS accredited as appropriate:

Course / Cost/unit / ED Nursing / SS Nursing / Total
PLS / 40 / 19 / 0 / 760
PILS / 62.5 / 21 / 0 / 1312.5
2072.5
Course / Cost/unit / ED Medics / SS Medics / Total
APLS / 540 / 4 / 1 / 2700

Multi-agency safeguarding training has been arranged for ED band 6 and 7 nursing staff at no cost to the Trust, and statutory/mandatory training will be fully up to date by January 2014.

2. ED Medical Staff Training Requirement

The review recommended that all members of staff at grade ST4 and above should be APLS trained.

Currently 5 of 6 ED staff grades are APLS accredited and1 Staff grade does not currently have a valid APLS accreditation. Of a total 6 ED consultants, one is currently APLS accredited. 3 consultants are booked onto an APLS course in October and November 2013.

The 2 remaining ED consultants and 1 remaining staff grade will book onto the next available locally run APLS course:

APLS / EPLS Training
Active Staff / Trained / Training booked / Training required
ED Consultants / 6 / 1 / 3 / 2
Staff Grades / 6 / 5 / 0 / 1

The review did not specifically recommend life support training for junior ED medical staff, but all new F2 trainees and ST1 trainees joining the department in August and September 2013 have completed PILS training, qualifying them to participate in paediatric resuscitation calls:

The review recommended that there should always be a paediatric trained member of medical staff on duty. Due to the complexity of managing ED medical staff rotas, it is essential that all ED medics should be up to date with statutory mandatory resuscitation training and level-3 safeguarding training at all times and this will be completed by January 2014.

3. ED Nursing Staff Training Requirement

The review recommended that at all times at least one nurse in the department should be APLS accredited.The division has reviewed the RCPCH guidance, which advises that ED nursing staff are trained to PILS/PLS level rather than APLS and training requirements have been assessed on this basis.

The division has determined that in order to ensure adequate cover, all band 6 and 7 ED staff should be PLS trained.There are 19 active staff at this grade, of which none are APLS trained. The Department has negotiated with Bristol Children’s Hospital to secure training at a cost of £40 per place, totalling £760. Training has so far been booked for 4 staff in November and a further 4 staff in December 2013. Training dates are awaited for January 2014 onwards and remaining staff will be booked onto courses as they become available.

Internal training has been booked to ensure that all ED nursing staff are compliant with statutory/mandatory resuscitation and level-3 safeguarding requirements by the end of December 2013. The review recommended that all ENPs should have completed multi-agency safeguarding training and the department proposes to extend this training to all band 6 and band 7 staff. This training will be undertaken in January 2013 at no cost to the Trust.

The review made no recommendation about life support training for band 5 staff, but in line with published RCPCH guidance, these staff will be trained to PILS level. As yet, dates for PILS courses have not been confirmed.

4. Seashore Medical Staff Training Requirement

The review made no specific recommendations about the desirable level of training amongst Seashore Centre medical staff. All 3 Seashore consultants are APLS trained although in one case this accreditation has lapsed and refresher training is necessary. This consultant will book onto the next available locally run APLS course.

All 3 Seashore consultants have in-date resuscitation training but only 1 consultant has up-to-date safeguarding level 3 training. Seashore consultants will book onto the next available training session and this will be completed by January 2014.

Seashore Nursing Staff

The review made no specific recommendations about the desirable level of training amongst Seashore Centre nursing staff.All members of staff are PILS accredited or have been booked on training courses during November 2013. All members of staff have completed multi-agency safeguarding training, although 3 members of staff do not have up-to-date level 3 safeguarding training and refresher training will be completed by January 2014.

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Luke Culverwell

ADM, Emergency Division

14/10/2013