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Adults cared for on children’s wards amid NHS pressures

RCN warns winter pressures are posing ‘major risks’ across the whole NHS system, but hospitals say temporary measures did not risk patient safety
Croydon University Hospital

Adult patients are being cared for on childrens wards due to unprecedented winter pressures in the NHS system, according to the RCN.

The safety concerns come after Croydon University Hospital and University Hospital Lewisham in London recently confirmed they had used childrens wards to treat adult patients, due to a shortage of beds.

There have been additional reports from RCN members that adults have been cared for on childrens wards during recent weeks.

More than four in ten hospitals in England declared a major alert in the first week of January, leading to a volley of warnings from healthcare experts.

Major risks

RCN professional lead for children and young peoples nursing Fiona Smith said current winter pressures were posing major

Adult patients are being cared for on children’s wards due to unprecedented winter pressures in the NHS system, according to the RCN.


Croydon University Hospital said a children’s ward was temporarily switched to offer
extra surgical beds for adults when needed. Picture: Alamy

The safety concerns come after Croydon University Hospital and University Hospital Lewisham in London recently confirmed they had used children’s wards to treat adult patients, due to a shortage of beds.

There have been additional reports from RCN members that adults have been cared for on children’s wards during recent weeks.

More than four in ten hospitals in England declared a major alert in the first week of January, leading to a volley of warnings from healthcare experts.

Major risks 

RCN professional lead for children and young people’s nursing Fiona Smith said current winter pressures were posing ‘major risks’ across the entire health service as problems in one area overflowed into others.

Ms Smith said: ‘Children’s intensive care services are under particular strain, with many seriously ill children being transported around the country to find a bed. 

‘The influx of patients also means that many adult patients are being cared for in children’s wards. Children and young people need a safe, nourishing environment with space for parents and carers, and the presence of adult patients can be highly distressing for both the child and their family. 

‘The rules are there for serious reasons. As pressure mounts, staff feel forced to find extraordinary solutions – but this must not include putting children at risk.’

‘Temporary’ switch

Croydon Health Services NHS director of nursing, midwifery and allied health professionals Michael Fanning said the measure was put in place to deal with extraordinary demand.

‘It is important to be clear that at no point were children and adult patients treated on the same wards,’ he said. ‘Like many acute hospitals this winter, we needed to open more beds to care for more people – for a short time, this included opening extra surgical beds on one of our children’s wards.

‘This allowed us to temporarily switch what would have routinely been a children’s surgical ward to treat adult patients only before and after their operations.’

Mr Fanning added that these measures meant the trust was able to keep its services running and was not forced to close its emergency department, or cancel any cancer, urgent or day case surgery.

Safety maintained

University Hospital Lewisham had to use one of its children’s short-stay beds to care for one of the 25 adults who needed to be admitted on Monday 9 January as an emergency, because of difficulties in accommodating the patients.

A spokesperson said that day was extremely busy, with high numbers of patients attending the emergency department and requiring admission. ‘We put our escalation procedures in place to ensure patient safety was maintained. In line with this, the paediatric short-stay unit was briefly used as an adult-only escalation area, while it was not required by children’s services.

‘Since that day, the children’s short-stay unit has not been used and there has been no impact on children’s services due to emergency pressures.

‘Our staff and our partners have been working hard and thanks to their efforts we have been able to ensure that patient safety is maintained, while treating the vast majority of patients who attend our emergency department within four hours.’


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