Earlier this year, we asked Fiona Houlihan, Professional Nurse lead at NHS Greater Glasgow and Clyde and Queens Nurse, to represent QNIS at a roundtable in the Scottish Parliament hosted by the Royal College of Paediatrics and Child Health and sponsored by Jackie Baillie, MSP. The event brought together MSPs, paediatricians and third sector stakeholders to discuss the impact of waiting times in paediatric services following the publication of the ‘Worried and Waiting: A Review of Paediatric Waiting Times in Scotland’ report by RCPCH Scotland.
Here she tells us about her experience:
Prior to attending I required approval from my NHS Board and this was agreed following communication with the Chief Officer, my General Manager, and my Nurse Director and Chief Nurse.
In preparation for the event I contacted fellow Queen’s Nurse, Kirsty Nelson Parish Nurse and alcohol and drug nurse specialist in Dundee. She walked me through her experiences in the past and this prepared me for timings, security checks, waiting areas and expectations in the room. We shared personal stories and this was very helpful indeed.
I read the papers, semi prepared some questions and statements (non GGC related) and felt empowered. I was ready.
The 3 recommendations that were being presented really stood out for me and this was my focus to ensure I remained on topic;
- The child health workforce that must be reviewed and include; a whole system approach, a bespoke child health workforce strategy, and engagement with children and young people.
- Data collection and improvements to include enhanced data, data on child health workforce strategy; and community paediatric monthly data.
- Access to services to consider cross sector capacity within primary care and community health services, empower and educate families, parents and carers, and support for children and young people in the community and at school.
On the train I met a retired health visitor, we exchanged pleasantries around our trip to the capital. She was going to theatre alone to see “Hamilton” but she explained she would much rather have had this experience and thanked me for my contribution and for doing my bit for children with disabilities in the community. This statement from a stranger caught me off guard but strangely also lifted me and I thought “yes I have got this”. It also made me think of a phrase I had read that angels come in different guises to guide and assist as I walked down the impressive Royal Mile to the Scottish Parliament fortress at the foot of Arthur’s Seat.
I met my colleague Dr Lindsay McKenna Maxwell, Community Paediatrician West Dun SCPT, who was also invited in her capacity as member of SACCH ( Scottish Association of Community Child Health).
Once in the room it became apparent that there was cross party representation of MSPs, Scottish Government, and public health and third sector stakeholders with an interest in child health and NHS waiting times. The aim being to agree priority actions to tackle waiting times and the challenges facing the service. The RCPCH definitely achieved raising awareness as later that day this issue was also raised at First Ministers questions by MSP Anas Sarwar. He detailed the waits from September 2023 with 10,512 children waiting to see a paediatrician, an increase from the 4,898 in October 2012 (this is for acute only). An increase of 114%.
The round table discussion itself was very interesting, it sparked my inner curiosity around proceedings. I observed closely and listened intently. The conversation was worrying but well-articulated by the speakers especially Dr Mairi Stark, RCPCH Officer for Scotland. Two of the four MSPs showed great interest and asked associated questions but perhaps only grasped a proportion of the gravity in my view.
My views and thoughts were that at this time we have a lot of work to do on paediatric waiting times as a collective across acute and community child health -our future generation is a priority as they are our greatest asset for our country’s stability, socially and financially, and their health care should be a priority. Never the less this inner political battle was personal to me and I mindfully stored this to unpack with my reflections later especially when two of the MSPs left the Burns room early after the presentation and before the discussion.
The report itself detailed that children and young people are experiencing excessively long waiting times and after initial referral feel they are left with lack of communication and feel forgotten. The RCPCH publication reported on these current challenges.
During the course of the discussion I did take to the floor and advocated for community paediatric child health services and children with disabilities and this was backed by my colleague Dr Lindsay McKenna Maxwell.
It was also acknowledged during the session that this is only the “tip of the iceberg” and doesn’t include Community Paediatrics or CAMHS waiting times and patient numbers.
The community psychiatrist consultant from the borders highlighted the internal CAMHS waiting lists that also exist.
One stand out comment for me from the roundtable was that “the body keeps the score” in that delays to paediatric care can have consequences in later life whether socially, academically, or health wise. The UNCRC and child’s rights agenda was weaved throughout and this was represented via the RCPCH & Us presentation detailing the views of the child.
Towards the end of the session the Cabinet Secretary for NHS Recovery, Health and Social Care, Neil Gray MSP, arrived. He spoke about his own family experience of the NHS, and during the course of his talk I noted the following quotes. He emphasized that “increased grants to health board’s budgets” have been provided and “that we are wrestling with a grim financial situation – doing what we can to invest”. He also mentioned “that health and social care budgets have been increased” and “that an element of reform and greater productivity and care needs to be sustainable against competing priorities”. He “recognises we can’t wait in paediatrics” the importance of “being seen by right people, right time, right place”. He ended by agreeing to visit the Family health and wellbeing clinics (a joint GP primary care and acute general paediatricians) a NHS Lothian project that had been described earlier in the day.
In summing up, Dr Mairi Stark stated that “we need to give the child health workforce the support it needs to care for the children and young people of Scotland. Only by tackling long waiting times can we provide the appropriate, holistic care that children need. Healthy children grow up to be healthy adults, so the time to act is now.”
To conclude I would like to thank NHS GGC and the QNIS who afforded me this opportunity to attend.
