Seriously ill children are being turned away from hospitals because of a “year-round” bed shortage in NHS critical care units, The Independent can reveal.
Hospitals in the Midlands, North West and London are struggling to meet demand even in the middle of spring – a time when services are normally less busy than in winter months – as they face an unexpected wave of sickness.
Doctors are instead being forced to send severely unwell children miles away for intensive care, and hospitals are cancelling vital operations, leaked documents and reports to The Independent reveal.
Labour has accused the Conservative government of “neglect” that has helped to push critical care for infants to crisis point.
The internal warnings from health officials come after nine-month-old Iona Grace Buckingham died in December 2022 from a Group A Strep infection after she was not able to be admitted to a critical care bed because none were available.
Iona was taken to Northampton General Hospital after developing bronchiolitis and a Strep A infection. She was admitted on 28 November 2022, and died six days later before she could be transferred to a paediatric intensive care unit (PICU) bed.
An investigation by the hospital following her death revealed that when doctors at Northampton requested she be transferred to a paediatric intensive care unit, there were no beds available in Leicester, Nottingham, Birmingham, Sheffield, Leeds, Manchester, or Cambridge.
‘Terrified’ parents
The local specialist team that carries out transfers from district general hospitals to PICUs was not able to reach Iona until four hours after the request from Northampton General Hospital was made, as it was dealing with two other patients.
A coroner later raised concerns over the fact that a blockage in Iona’s lung had initially been missed and was not picked up until she was critically unwell, as the trust only had a paediatric radiologist working from 9am to 5pm Monday to Friday.
Iona’s father, Christopher Buckingham, told The Independent: “I remember at the time, on the afternoon of Sunday 4 Dec 2022, how terrifying it was to be told Iona needed to be transferred to PICU and it would have to be done by the specialist team, but there were currently no beds and the team wouldn’t be able to reach the hospital for several hours.”
Dr Imogen Staveley, interim chief medical officer at Northamptonshire Integrated Care Board, and Hemant Nemade, medical director at Northampton General Hospital, said the trust was saddened by Iona’s death, and that, following the inquest, it had reviewed recommendations and responded to the coroner.
One in five children were turned away from intensive critical care in the last three months of 2022, according to data obtained by The Independent.
One leaked national NHS report showed that, across all services in England, just 15 new PICU beds were opened between 2020 and 2023, despite rising demand.
Responding to The Independent’s findings, Labour’s shadow health and social care secretary Wes Streeting said: “Rishi Sunak claims the NHS is turning a corner, while children in need of critical care are turned away from hospital. 14 years of Conservative neglect means the NHS cannot be there for sick children when they need it.”
Dr Ronny Cheung, officer for health services at the Royal College of Paediatrics and Child Health, warned that intensive care units for children and babies across the country are more than 90 per cent full despite the time of year.
He told The Independent: “There continue to be shortages of paediatric critical care beds, which are no longer seen in just the times of winter pressures but now happen all year round.
“[Spring and summer] should be the period where you would have a bit of respite ... But the fact is that we can’t accommodate them, and so cases are being cancelled at the moment due to lack of intensive care capacity.”
One senior doctor, speaking anonymously, said that the current pressure on children’s intensive care is the worst they have ever seen.
They said: “The impact on staff and moral distress is huge, and multiple staff are leaving.”
Additional data analysed by The Independent found that NHS hospitals are unable to meet rising demand, with nearly one in five exceeding their capacity in critical care units in the last quarter of 2022 alone.
Acutely unwell
Not every NHS hospital has a paediatric intensive care unit. They are located in 21 hospitals with specialist skills, across 19 NHS trusts, and sick babies and children who need beds are transferred there.
There are 299 “level three” beds across the NHS, which are for the most seriously ill children, and 171 “level two” beds, in what are known as high dependency units (HDUs), which are for less unwell children.
Leaked emails from April reveal concerns from national NHS leaders and local hospitals with critical care units that Birmingham Women's and Children's NHS Foundation Trust was “surging” with acutely unwell children, beyond the number of beds it has funding for.
However, the emails say that there is no clear reason for there being such an increase in the number of sick children.
Birmingham Women’s and Children’s trust, which runs the PICU for the area, said it had higher than usual unplanned admissions to its unit in April, but that demand has since dropped.
During this period it was unable to admit nine patients, who were sent elsewhere – in the same month last year, it only rejected two.
The above map shows which NHS hospitals have been hit the hardest in each quarter, meaning that they are often unable to meet demand for paediatric critical care beds, which can mean that children are turned away from receiving the urgent critical care they need.
Figures show that more and more children were being turned away from intensive critical care in 2022 – an average of 12.7 per cent of patients.
Hospitals often over capacity – but hardly any new beds added
Despite hospitals being frequently overwhelmed, the NHS has added just 15 critical care beds across the country in the past three years (2020-23), according to a leaked report, with some hospitals having fewer beds than before.
Clinicians have warned that a lack of HDU beds (level 2), which are for children who are less unwell but still in need of intensive care, means that they cannot move children out of PICU, which causes a backlog in care.
A recommendation in April 2023 suggested that all hospitals should have a minimum of one HDU bed for every two PICU beds, but many hospitals have failed to meet this target.
An NHS spokesperson said: “While there is ongoing demand for these services, the NHS has tried-and-tested surge plans in place, which include mutual aid between hospitals and paediatric specialist units to ensure services are able to provide the highest quality care to all children.”
The government was approached for comment.
