The lack of specific targets in the NHS Long Term Workforce Plan for increasing the number of children’s nurses has been raised as a concern to the Thirlwall Inquiry.
The Royal College of Paediatrics and Child Health (RCPCH) warned of a year-on-year decline in nurses working in neonatal services in England’s health service.
“We do recommend greater funding and investment in the neonatal workforce”
Fiona Scolding
The Thirlwall Inquiry is looking at the circumstances surrounding the case of Lucy Letby, who has been convicted of murdering seven babies, and attempting to murder seven others, while working as a neonatal nurse at the Countess of Chester Hospital in 2015 and 2016.
In a witness statement to the inquiry, Dr Camilla Kingdon, who, until March 2024, was president of the RCPCH, flagged a “lack of financial resource for children’s services”.
She said this funding problem “often results in significant workforce constraints, risking poorer quality of care” and that the “continuing decline” in neonatal nurse staffing levels was a particular concern.
Dr Kingdon then went on to highlight that the NHS Long Term Workforce Plan – published in June 2023 – had made “no commitment to investing in growing children’s nurses, compared with an almost doubling of adult nursing training places by 2031”.
The same issue was raised by RCPCH lawyer, Fiona Scolding KC, during her closing statement to the Thirlwall Inquiry on Monday.
Ms Scolding said that “given the difficulties with the workforce, it is somewhat disappointing that the NHS Long Term Workforce Plan doesn’t include anything specific about paediatric nurses”.
Lady Justice Thirlwall, chair of the inquiry, addressed NHS England’s lawyer, Jason Beer KC, about the lack of children’s nurse targets in the workforce plan.
In response, he said: “I think from memory, when you go back and look, topics tend to be addressed generically under the plan… ie uplifts or similar under the plan, rather than by specialist area.”
Lady Thirlwall asked Mr Beer to come back to the inquiry at a later date to clarify whether the plan – an updated version of which is due to be published this summer – made any provision for more neonatal nurses.
Meanwhile, Ms Scolding called for “greater funding and investment” in the neonatal workforce, including nurses but also doctors, allied health professionals, pharmacists and psychologists.
She said: “We accept what NHS England has said that investment has been made more generally in maternity and neonatal services.
“However, given that in particular the chronic understaffing in neonatal care has been a long-term problem, dating back at least 15 years, it is disappointing to the royal college that there has not been greater focus upon that in the long-term workforce plan at the moment.”
She added: “We do recommend greater funding and investment in the neonatal workforce – including medical, nursing, allied health professionals, pharmacy and psychology – to achieve the required national standards to improve safety, and to train and develop the workforce to retain our valued staff.
“We would suggest that the evidence from this inquiry shows unequivocally the need for such investment.”
The Thirlwall Inquiry held its last oral evidence session this week and the chair will now compile her report of findings and recommendations, which is expected to be published in November.
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