Thread by @Highland_Laser

Hi Richard, I'm a paediatric nurse with specialist training in critical care & with experience of advising boards on allocation of resources to maximise safety of sick kids in areas suffering access deprivation of health care services. Can we debate this issue sensibly please?

I understand that @scottishlabour needs a lot of work, but it's a shame you are unwilling to talk about this. Forgive me if i push ahead without you, but please feel free to jump in at any time.

Your colleague @LewisMacdMSP had the honour of prefacing the Emergency Care Framework for Children & Young People, a document produced by @ScotGov (nee executive) back in 2006 following extensive consultation of stakeholders: ihub.scot/media/2449/eme…

This important work has served as the blueprint for Scottish paediatric care provision ever since & I congratulate everyone who was involved in its development regardless of what political party they might have been affiliated with.

I recommend anyone interested in these issues to read this report to inform decision making & develop understanding of the practical considerations that surround the RAH Children's Ward closure. Sick kids should be looked after in child-friendly facilities at all times

This is bigger than the ward, It includes reception, imaging, physiotherapy, and perception of the hospital as a whole from a child's point of view. Little people are complex. Hospital is a scary place at the best of times & this can have real clinical implications

Then there are the safety issues. Sick kids in a District General need a whole host of highly trained paediatric staff to provide services outwith the ward environment: Pharmacy, physiotherapy, dietetics, imaging, critical care escalation pathways & more

Usually, there are only 1 or 2 people from each of these disciplines available to provide this expertise within working hours. Out of hours, there's usually NONE. No paediatric resus teams, no paediatric anaesthetist, no paediatric surgeons, no onsite paediatric consultant...

And then there's the COST. The Scottish budget is fixed and largely hostage to Tory #Austerity via the Barnett formula. NHS spending is prioritised, but the money has to be diverted from other services. All these highly skilled specialist paediatric RAH staff are expensive.

So - much safer, cheaper, and all round better to cater for these sick paediatric inpatients at a dedicated brand new Children's hospital which is fully staffed with specialised paediatric health care professionals 24/7/365 within a child friend environment

Particularly if that hospital is less than 6 MILES DOWN THE ROAD (thanks @WingsScotland), and that investment will be made to ensure staff are available to facilitate and escort paediatric transfers:

Particularly if RAH A&E continues to provide paediatric care to sick children & stabilise critically ill children with @Scot_STAR support AS ALREADY HAPPENS: nhsggc.org.uk/get-in-touch-g…

Centralisation of specialist services can be easily misconstrued as cuts & public opinion is ALWAYS opposed to closing services. Media love to whip this up into a frenzy & MP's & MSP's aren't immune to the pressures of political expediency

I don't live in Paisley, but if my kid was sick would I prefer she goes to RAH or RHSCG? I'd choose the world class paediatric teaching hospital every single time, regardless of the extra 5.5 miles or the extra 5 minutes in a blue light ambulance it would take to get there

A paediatrician ex-colleague has also highlighted the UK wide RCPCH guideline "Standards for acute general paediatric services". Regular meetings occur at regional & national level in Scotland tasked with developing systems to meet & exceed these standards rcpch.ac.uk/sites/default/…

Recommended staffing levels for paediatric inpatient services are onerous, but are vital to ensure the safety of sick kids. The standards repeatedly state that the No. 1 key recommendation is to reduce number of inpatient sites to concentrate resources in regional supercentres