Bed pressures in Paediatric Intensive Care Units (PICUs) are always extremely challenging during winter months due to surges in viral respiratory illnesses. This impacts upon available PICU beds in every unit, which may result in adverse patient experiences, such as cancellation of elective cardiac surgery, and lengthy transfers of critically ill children to other regions of the country to gain access to a PICU bed.
Epidemiological data indicate that this winter, in particular, is likely to be particularly severe, and many parts of the world are experiencing high levels of illness in young children.
The UK has already seen a significant spike in demand for access to paediatric critical care beds in the last few weeks. Many PICUs are at, or over, their staffed bed capacity. This situation is likely to continue, or even worsen, over the coming months. Colleagues around the country have informed us that the following additional challenges are contributing to the exceptional pressures on bed capacity:
• Staffing shortages in some PICUs resulting in significant strain across the wider paediatric critical care workforce.
• Staffing shortages outside PICUs (e.g., in high dependency, inpatient ward areas and social care) that are leading to delayed discharges of patients from PICUs.
• An increasing number of patients with medical complexity and technology-dependence that is resulting in a greater proportion of paediatric critical care beds being occupied by children who have a very prolonged hospital stay.
NHS England and PCCS are working collaboratively to enact winter escalation plans to ensure children and young people requiring paediatric critical care receive the best treatment as close to their home as possible. Finally, PCCS would like to acknowledge and support all the doctors, nurses, and allied health professionals who are working under exceptional pressure at this time.
Carli Whittaker, President PCCS