St John's hospital children's ward 'should remain'
St John's hospital in West Lothian should continue treating sick children as well as adults, according to an independent report.
Low staffing levels have led to temporary closure of the Livingston children's ward on several occasions.
It had been proposed that all children could travel to a new children's hospital being built in Edinburgh.
But an independent review has recommended children's services be retained in Edinburgh and Livingston.
However, it is dependent upon staff agreeing to provide more out-of-hours cover.
NHS Lothian board members will meet on Wednesday to look at the recommendations.
The Royal College of Paediatrics and Child Health (RCPCH) was asked to review paediatric services at the Royal Hospital for Sick Children, St John's Hospital and the Royal Infirmary of Edinburgh.
The RCPCH has suggested three main options for securing the children's ward at St John's Hospital and has identified option one and two as being "the most suitable".
It has also recommended an increase in the number of consultants based at the Royal Hospital for Sick Children to help meet the rise in the number of admissions.
NHS Lothian board members are being asked to approve the recommendations in the report - adopting option one for St John's Hospital, while using option two or a variation of this option agreed with the team at St John's, as an interim solution while the staffing infrastructure is developed.
Option one, which is the college's recommended option, is to have consultants staying overnight in the hospital, which all consultants at St John's Hospital would be required to support.
This would see each consultant do "occasional" overnights to provide on-site senior presence, supported by a non-resident consultant on-call from home.
Option two is presented by the college as a possible interim option while progressing option one.
This option would see the children's ward at St John's Hospital providing overnight inpatient care as a 24-hour 'low acuity' unit, which does not admit children overnight when consultants are not present.
Out-of-hours cover would be provided by a mixture of advanced practice nurses and medical staff, with a non-resident consultant on-call from home.
The board is being asked to agree to an interim option being put in place from the end of August 2016.
Option three would see the children's ward operate as a Short Stay Paediatric Assessment Unit (SSPAU) open from 08:00 to 22:00, with no overnight accommodation.
Jim Crombie, NHS Lothian's chief officer of acute services, said: "I want to ensure that we can deliver the safest services for children across Lothian which is why we commissioned the experts at the Royal College of Paediatrics and Child Health to carry out an independent review.
"As we fully expected, the review team reflected the concerns and aspirations shared by staff and have been able to identify areas where we can make improvements to ensure we continue to deliver high quality person-centred care.
"We have a number of recommendations, in relation to recruitment, changing working patterns and fostering closer relations between departments, and we now need to discuss these with our staff, who are pivotal in moving forward."