Charity Starlight highlights the need for play to reduce healthcare-induced trauma
Only one in four (25%) health boards in Scotland report having budgets for essential mental health play services for seriously ill children, according to a freedom of information request carried out by Starlight, the national charity for children’s play in healthcare.
Areas with the most children living in areas of highest deprivation tended to have less or no resourcing. As noted in Starlight’s recent report2, these children are most at risk of trauma.
Cathy Gilman, chief executive of Starlight said: “Play services, which include evidence-based activities, games and toys, are one of the most effective ways to reduce trauma in children undergoing healthcare treatment.
“It can explain complex procedures in child-friendly ways, distract children from pain and help professionals do their jobs by reducing children’s stress.
“The lack of budget for this vital support in Scotland is as shocking as it is sad, with so many children facing incredibly harrowing circumstances without support.”
Starlight’s research also revealed that even those trusts with budget for play services did not extend support to evenings and weekends – quiet periods that can be hardest of all for children to face.
Claire’s daughter Lucy, 12, has had a rare condition affecting her oesophagus and trachea since birth. Claire said: “We live two hours away from Aberdeen and Lucy’s dad is in the RAF, so it’s hard for him and Lucy’s two siblings to visit when we are staying there, and other family are five hours away.
“This means it’s usually just me there, so having the play workers in hospital organising fun things to do, for example face painting and having visits from exotic animals, means that Lucy can have some fun, and I can do things such as have a shower, and not have to worry about her being alone in hospital, as I know she is with the play workers and having fun.”
Heather Beattie, play service manager at Royal Aberdeen Children’s Hospital, said: “I genuinely believe that a paediatric hospital couldn’t function properly without a solid, well-trained play team.
“Play is such a vital component of creating a positive experience for both the child and their family and is an inseparable part of their treatment journey.
“You can’t separate children from play, it’s inherent to who they are. But it’s crucial that this play is appropriate and provided by trained professionals who understand the unique needs of these young patients.”
In October 2024, Heather’s team won Play Team of the Year award at Starlight’s annual Play in Healthcare Awards.
Kids Operating Room and Smile Train successfully install solar surgery systems in 23 hospitals across Nigeria
The Solar Surgery system ensures reliable power for medical equipment during surgeries, addressing frequent power cuts
Initiative boosts patient safety and surgical outcomes, and reduces carbon emissions
Partnership aims to upgrade more than 30 paediatric theatres across Africa by 2025
Kids Operating Room (KidsOR), the Scottish charity dedicated to ensuring every child has access to safe surgery in low- and middle-income countries (LMICs), and Smile Train, the world’s largest cleft-focused charity, announce the successful implementation of the Solar Surgery system in 23 hospitals across Nigeria.
In their groundbreaking partnership, the two organisations are taking significant strides to enhance surgical care in Nigeria through the creation of new surgical facilities, training of local surgical teams, and now the deployment of solar powered operating theatres to ensure every child has access to a safe operation, free from the risks of power outages.
Solar panels have been installed on the roofs of the operating facilities in Nigeria, charging smart battery units that power vital medical equipment in an operating room. This innovative approach combats the frequent power cuts experienced in many African hospitals, ensuring uninterrupted care and better outcomes for patients.
The system monitors what power is needed by the surgical team and provides that directly from the panels, meaning children across Nigeria are now having operations powered entirely by the sun. However, the system can seamlessly switch to a blend of solar and battery power on cloudy days and can go on to provide 8-hours of continuous use into the night. Only when there is no sunlight, and the reserve is being depleted will the system start to pull power from the local grid.
The partnership between KidsOR and Smile Train promises to deliver reliable power to Nigerian hospitals, improving patient safety and improving surgical results while also reducing the carbon emissions of the facilities – setting a sustainable standard for medical treatment across Africa.
Globally, one in 700 babies are born with a cleft lip and/or palate. Sadly, many of these children miss out on the vital reconstructive surgery they need, which can lead to challenges in eating, breathing, and speaking. Smile Train is the world’s leading charity focused on transforming the lives of these children and recently announced supporting their 2 millionth cleft surgery.
Nkeiruka OBI, Vice-President and Regional Director, Africa of Smile Train, commented:“Erratic power supply is a norm in Nigeria, like most developing countries. Interruption of power during a surgical procedure could jeopardise the life of the patient. It is not a desirable experience.
“By harnessing clean and renewable solar energy, which by the way we have in abundance in this part of the world, surgical teams can confidently operate critical medical equipment and ensure that children with clefts can receive safe, timely surgeries regardless of power outages.
“The solar-powered theatre is a game changer, in transforming healthcare delivery across Africa, especially in areas where unreliable power limits access to safe surgical care.
“With each solar-powered theatre, we take a step closer to universal access to safe surgery, amplifying the impact on children, families, and entire communities. Smile Train and KidsOR’s partnership truly serves as a model on how meaningful collaboration and innovation can overcome healthcare challenges and drive sustainable change across the continent.”
David Cunningham, CEO of KidsOR, commented: “Our partnership with Smile Train is making a life changing difference to children in developing countries across the globe. In Nigeria, and across Africa, we are working with Smile Train to pave the way for a future where no child has to fear a power outage as a significant risk to their life during an operation.
“In Nigeria, we will shortly have moved 30 operating rooms onto the exciting Solar Surgery system, which means surgical facilities across the country will be able to operate at full capacity and are no longer restricted by frequent power outages.”
Members of the public are being urged not to visit hospitals if they are displaying symptoms of vomiting or diarrhoea, or if they have been in contact with anyone who is unwell.
NHS Greater Glasgow and Clyde (NHSGGC) issued the advice to those who are planning to visit loved ones in hospital.
The health board said anyone with vomiting or diarrhoea symptoms, or anyone who has been in recent contact with someone with these symptoms, should not visit until they feel better.
It comes amid a rise in winter related illnesses including Norovirus, Gastroenteritis, COVID-19 and flu across Scotland.
Visitors are also reminded to practice good hygiene by ensuring they regularly wash their hands to prevent the spread of viruses.
Nausea, vomiting and diarrhoea are common symptoms of these illnesses, along with headaches, fever and muscle or limb pain.
Symptoms of Gastroenteritis include:
Suddenly feeling sick
Projectile vomiting
Watery diarrhoea
Slight fever
Headaches
Painful stomach cramps and aching limbs
Symptoms of COVID-19 include:
Continuous cough
High temperature, fever or chills
Loss of, or change in, your normal sense of taste or smell
Shortness of breath
Unexplained tiredness, lack of energy
Muscle aches or pains that are not due to exercise
Not wanting to eat or not feeling hungry
Headache that’s unusual or longer lasting than usual
Sore throat, stuffy or runny nose
Diarrhoea
Feeling sick or being sick
Symptoms of flu include:
A sudden fever
A dry, chesty cough
A headache
Tiredness and weakness
Chills
Aching muscles
Limb or joint pain
Diarrhoea or abdominal (tummy) pain
Nausea and vomiting
A sore throat
A runny or blocked nose
Sneezing
Loss of appetite
Difficulty sleeping
In recent years, taking precautions against viral infections have become part of our daily life and we can all continue to help each other by following guidance around slowing the spread of viruses and practicing good hygiene.
You can protect yourself and others by staying at home if you are unwell and by cleaning hands and surfaces regularly.
Dr Aleksandra Marek, Consultant Microbiologist and Infection Control Doctor, said: “We are asking anyone with symptoms including vomiting or diarrhoea, or anyone who has been in contact with someone who has these symptoms, not to visit our hospitals.
“During the winter months, illnesses such as Norovirus, Gastroenteritis, COVID-19 and flu, can add to the pressures that staff face across our sites.
“To help protect yourself, your loved ones and our services, we are asking members of the public not to visit our hospital sites if they are displaying symptoms of any of these viruses.
“We are also asking anyone who does attend a site to follow infection control guidance, such as washing your hands regularly.”
NHSGGC is urging people to only attend Emergency Departments (A&E) if their condition is very urgent or life-threatening.
Any patient unsure of who to turn to has a range of options available to them:
Members of the public are being reminded not to visit NHS Greater Glasgow and Clyde hospitals if they have symptoms of Gastroenteritis, COVID-19 or flu.
Anyone planning to visit a loved one in hospital should not do so if they are displaying any symptoms including sickness and diarrhoea.
All visitors should also practice good hygiene by ensuring they regularly wash their hands to prevent the spread of viruses.
Nausea, vomiting and diarrhoea are common symptoms of Gastroenteritis, flu and COVID-19, along with headaches, fever and muscle or limb pain.
Flu and COVID-19 symptoms also include coughs, chills, a sore throat and a blocked or runny nose.
Symptoms of Gastroenteritis include:
Suddenly feeling sick
Projectile vomiting
Watery diarrhoea
Slight fever
Headaches
Painful stomach cramps and aching limbs
Symptoms of COVID-19 include:
Continuous cough
High temperature, fever or chills
Loss of, or change in, your normal sense of taste or smell
Shortness of breath
Unexplained tiredness, lack of energy
Muscle aches or pains that are not due to exercise
Not wanting to eat or not feeling hungry
Headache that’s unusual or longer lasting than usual
Sore throat, stuffy or runny nose
Diarrhoea
Feeling sick or being sick
Symptoms of flu include:
A sudden fever
A dry, chesty cough
A headache
Tiredness and weakness
Chills
Aching muscles
Limb or joint pain
Diarrhoea or abdominal (tummy) pain
Nausea and vomiting
A sore throat
A runny or blocked nose
Sneezing
Loss of appetite
Difficulty sleeping.
In recent years, taking precautions against viral infections have become part of our daily life and we can all continue to help each other by following guidance around slowing the spread of viruses and practicing good hygiene.
You can protect yourself and others by staying at home if you are unwell and by cleaning hands and surfaces regularly.
Dr Aleksandra Marek, Consultant Microbiologist and Infection Control Doctor, said: “During the winter months, illnesses such as Gastroenteritis, COVID-19 and flu, can add to the pressures that staff face across our sites.
“To help protect yourself, your loved ones and our services, we are asking members of the public not to visit our hospital sites if they are displaying symptoms of any of these viruses.
“We are also asking anyone who does attend a site to follow infection control guidance, such as washing your hands regularly.
“Our dedicated members of staff are working around the clock to continue to provide the highest standard of patient-centred care possible.”
NHSGGC is urging people to only attend Emergency Departments (A&E) if their condition is very urgent or life-threatening.
Any patient unsure of who to turn to has a range of options available to them:
Speaking in Tuesday, Calum Campbell, Chief Executive, NHS Lothian, said the healthcare system was under extreme duress as a result of an increase in the numbers of emergency patients, large numbers of delayed discharge patients and an increase in respiratory illnesses.
He said teams at the Royal Infirmary of Edinburgh, St John’s Hospital, the Western General Hospital and the Royal Hospital for Children and Young People were all being pushed to the limit.
To help free up vital beds, he said that some relatives may be asked if they can provide care to their loved ones as an interim measure while those packages of care to help in their own homes are put in place by their local Health and Social Care Partnership.
He said: “These challenges are unprecedented, but they are also sustained. We need people in Lothian to help their own communities and the NHS.
“We have large numbers of people waiting to be admitted into a hospital bed, so I would urge everyone who is asked to provide care to their loved one to give the request some serious consideration.”
Dr Tracey Gillies, Medical Director, NHS Lothian, said: “Our teams will have carried out a robust clinical assessment before they discuss the temporary possibilities with patients and their families.
“We know that most patients want to return home as soon as they possibly can, especially at this time of year. This would also help our teams and the patients waiting to be admitted.
“Also, if you have a loved one in hospital who has been discharged and requires to be collected, please do so as early in the day as possible.”
The primary care sector in Lothian also experienced one of its busiest days to date on Monday (19th December) as they provided care to increasing numbers of adults and children, especially families with concerns around Strep A following recent increases in the virus.
Jenny Long, Director of Primary Care, NHS Lothian, urged people to remember that there were a number of winter viruses in circulation and to consider NHS Inform and their local pharmacist for help and advice, use over the counter medication, drink plenty of fluids and rest.
Cold-type symptoms such as a runny nose or mild cough are more likely to suggest a viral illness.
If you have a sore throat, but can eat and drink, and don’t have a very high temperature then it is likely to be a common virus and there is no need to contact your GP.
The most up to date information on Strep A can be found at
“These are the second worst data on record. Too many patients are waiting too long. We know long waits contribute to patient harm. In August over 29,000 patients waited over 12 hours after a decision to admit was made, with some patients waiting up to three days for a bed.
“We think the consequence of this is shown in the ONS data as 500 excess deaths a week. We must not accept these long stays as normal. We need to see leadership and meaningful action that gets to grips with this crisis.
“We urge the new Prime Minister, Liz Truss, and incoming Health and Social Care Secretary, Therese Coffey (above), to make tackling the crisis in Emergency Care a priority.
The scale of patient harm occurring is shocking. The Emergency Care system is failing to its core functions; it is vital that we mitigate the impact of this crisis ahead of winter and do all we can to keep patients safe and reduce these dangerous waiting times.
“The Prime Minister and Health Secretary must urgently bolster the social care workforce. Thousands of beds are occupied by patients who are medically fit to be discharged, but the lack of social care service means that getting patients home is a slow and complex process.
“This means that hospitals have difficulty in discharging patients in a timely way, leading to exit block, poor flow throughout the hospital and subsequent problems in Emergency Departments and ambulance waits. The need for investment in social care couldn’t be clearer.
“Staff are exhausted, overwhelmed and in the midst of the worst crisis the NHS has ever faced. Widespread shortfalls of staff across all grades and departments mean health care workers are spread increasingly thinly and more prone to burnout – there are currently around 130,000 vacancies in the NHS almost 10% of its workforce.
“The Prime Minister must deliver the fully funded long-term NHS workforce plan that the government pledged to deliver in 2019. Emergency Care is in crisis and there is a shortfall of 2,000-2,500 Emergency Medicine consultants and widespread shortages of vital nursing staff, trainees, SAS doctors and junior and supporting staff are contributing to the challenges.”
There were 1,304,378 attendances at major Emergency Departments
There were 1,988,779 total attendances at all Emergency Care facilities
28,756 patients were delayed for 12 hours or more from decision to admit to admission
This is the second highest number of 12-hour waits on record, just 561 short of the previous record in July 2022
There have now been 178,770 12-hour waits (from decision to admit to admission) so far this year
Four-hour performance at major Emergency Departments was 58.0%, this is the second worst four-hour performance on record, the lowest was recorded the previous month, July 2022
More than 2 in 5 patients were delayed by four-hours or more
Type 1 admissions stood at 350,618 (a daily average of 11,310)
130,528patients spent more than four hours in an Emergency Department from decision to admit to admission (also referred to as ‘trolley waits’)
Bed occupancy stood at 92.8% (far higher than the recommended 85%)
NHS Lothian is delighted to announce the launch of its Summer Youth Volunteering Programme. The programme offers young people aged 16-24 the opportunity participate in a series of taster volunteering experiences over a five week period in one of our Acute or Community Hospitals.
Young people participating will gain –
· The opportunity to gain insight into the NHS Lothian and careers in health care
· The opportunity to build confidence and develop skills
· A reflective workbook to identify new skills and experiences to support applications for work or study
· Travel expenses
· Volunteer uniform
· Young Scot Points
· A reference on completion of the summer programme
· The opportunity to volunteer to extend volunteering beyond the summer programme commitment if desired
· You can also use the volunteering hours towards a Duke of Edinburgh or Saltire award
We are currently accepting applications. The closing date for applications is the 3rd of June.
If you have any queries about the Summer Youth Volunteering Programme or would like a member of the Voluntary Services Team to speak to a group of young people or to your colleagues, then please contact Head of Volunteering Jane Greenacre via jane.greenacre@nhslothian.scot.nhs.uk
Visits to people in hospital and care homes to continue with additional protection measures
Visitors to hospitals and adult care homes are being asked to take an LFD test before every visit under new guidelines.
Adult care homes and hospitals should continue to support visits for residents and patients, however new recommendations set out that visits should be in line with the rules for the general public brought in to control the spread of the Omicron variant of Covid-19.
The guidance stresses that residents in adult care homes should continue to have opportunities to connect safely with their loved ones, if the protective measures to support safe visiting are maintained.
Under new guidelines no more than two households should meet with a resident at any one time inside the care home and residents are asked to avoid larger gatherings when visiting friends and family outwith the care home.
Staff testing has increased to daily and all visitors should test before every visit. As before named visitors can still be supported to visit residents in care homes with a controlled COVID-19 outbreak if the local Health Protection Team has agreed this can happen. Essential visits in circumstances such as distress or end of life should be compassionately and generously supported at all times.
Hospital visiting must continue to be prioritised, with appropriate precautions and protections. These include asking all visitors to use an LFD test ahead of visiting, and for no more than two people to visit a patient at any one time, on wards where there is no current active outbreak. Where an active outbreak is being managed, hospitals should allow essential visits only.
Health Secretary Humza Yousaf said: “We are clear hospital visiting must continue, with appropriate precautions and protections in place. We are also mindful of the imminent Christmas period and what this means for patients, staff, visitors and communities.
“Our expectation is that every patient in hospital in Scotland over the Christmas and New Year holiday period should be able to benefit from the support of at least one visitor and, wherever it is safely possible, two.
“These additional measures, in recognition of the rapid spread of the Omicron variant, are on top of existing infection prevention and control measures. As has always been the case, we expect protections such as hand hygiene, face coverings and distancing to continue to be maintained.
“The additional protective measures for adult care homes aim to balance the current Covid-19 risk and the need to keep people safe in line with clinical advice provided about the risks of Omicron variant of COVID-19 at this time.
“Anyone who visits a hospital or care home should undertake an LFD test before every visit in order to keep patients and residents safe. However the additional measures in care homes and hospitals are based on the principle that, using all the protective measures, people living in care homes or being treated in hospitals should continue be supported to see and spend time with those important to them.
“It is vital that everyone works together to enable people to see each other in the lead up to and over the Christmas period so that everyone can spend time with one another safely and with confidence.
“I want to take this opportunity to thank all health and social care staff who have worked tirelessly to enable people, whether patients or care home residents, to stay connected with their loved ones. Their contribution has been immense.”
Nearly two thirds of A&Es across the UK had ambulances waiting to transfer patients every day in the past week, according to a new survey from the Royal College of Emergency Medicine.
The latest RCEM survey covers the period 8 November to 14 November 2021 and was sent to Clinical Leads in Emergency Departments across the UK and received 70 responses.
The NHS mandates that ambulance handovers ought to be reliably completed within 15 minutes of arrival, but 61% of Emergency Departments in the survey were struggling to meet this standard every day.
The survey also found that over half of Emergency Departments had provided care to patients in non-designated areas such as corridors every day in the past week.
These findings come following a report by the Association of Ambulance Chief Executives (AACE) which found that 160,000 patients may be coming to harm annually as a result of ambulance handover delays.
While a separate report by the Royal College of Emergency Medicine, ‘Crowding and its Consequences’, found that at least 4,519 patients have died as a result of dangerous crowding in Emergency Departments in England in 2020-2021.
14% of respondents stated that the longest stay they had had in their Emergency Department was between 48 and 72 hours
36% of respondents stated the longest stay in their Emergency Department was 24 to 48 hours
39% of respondents stated the longest stay in their Emergency Department was 12 to 24 hours
14% of respondents stated that there was no effective Same Day Emergency Care available in their Emergency Department
50% of respondents stated that Same Day Emergency Care had limited availability, less than 12 hours a day or weekdays only in their Emergency Department
71% of respondents stated that they were unable to maintain social distancing for patients in their Emergency Department in the past week
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:“These results show the serious state that our urgent and emergency care system is in.
“None of us want to have patients held in ambulances, treated in corridors, or waiting very long times to go up to a ward bed. Sadly, these findings support our stark report on crowding and the AACE’s shocking report on ambulance handovers.
“We all need to work together to solve this acute patient safety problem. We believe enacting many of the suggestions we have made in RCEM CARES: The Next Phase will help. We want patients to feel confident that their Emergency Care system is there for them, but this winter is going to be a huge challenge unless we can get flow back into the system.
“RCEM CARES: The Next Phase details our system-wide plan to tackle the current crisis and improve patient care as well as staff wellbeing. In the short-term, to promote flow and to reduce handover delays, capacity must be expanded in a safe way. Same Day Emergency Care must be made available at all Trusts and they must expand its provision, so it is available 12 hours a day, seven days a week. While maximising the service Discharge to Assess will allow patients to be discharged in a timely and supported way.
“In the long-term, we urge the government to publish a long-term workforce plan, this must include actions to retain existing staff as well as recruit new staff. Across the UK there is a shortfall of 2,000-2,500 WTE Emergency Medicine consultants, and crucially, there are also widespread shortages of Emergency Medicine nurses and both junior and supporting staff. At the same time capacity is severely depleted across the UK. The government must restore bed capacity to pre-pandemic levels, this requires an additional 7,170 beds across the UK.
“This is only the beginning of winter and of what may come. We are facing a crisis in urgent and emergency care and a crisis of patient safety. The Secretary of State in the House of Commons spoke of ‘a duty to avoid preventable harm of everyone working in health and social care’, we urge him to act on his own words and prevent avoidable harm and ensure the safety of patients.”
Managing Director of AACE Martin Flaherty OBE QAM said:“These alarming new figures from RCEM underline once again the unprecedented pressures facing the entire urgent and emergency care system.
“We now know that excessive handover delays and crowding in A&E departments are routinely harming patients, some very severely. To resolve this, we need system leaders to further toughen their resolve to deal with this problem once and for all and as a matter of priority and we await details of progress being made in this area, while underlining our commitment to work as part of the solution to this complex issue.”
Tracy Nicholls, Chief Executive of the College of Paramedics, said:“We must not forget that behind all these mounting figures are real people, both staff and patients, who are bearing the brunt of this continuing strain on services.
“Reform must happen to alleviate the intolerable pressure and reduce the guilt many paramedics and Emergency Department staff feel about dealing with patients who are waiting outside Emergency Departments or, more worryingly, in the community.
“We support any efforts to deal with the here and now, but we commit to working with stakeholders and partners to make real change happen.”
Humza Yousaf: “This winter is likely to be the most challenging in the history of the NHS”
The Scottish Government is investing an additional £10 million to help patients avoid a hospital stay wherever possible – and to prevent delayed discharge for inpatients.
This is part of a range of actions included in the £300 million winter package of funding to health and social care services, and outlined in the health and social care winter plan, to take the pressure off hospitals and frontline staff.
Two new programmes – Interface Care and Discharge without Delay – will support NHS Boards to explore alternatives to hospital inpatient care where appropriate, and improve the discharge process for those who do need to be admitted to hospital.
Interface Care, backed by an additional £6 million this financial year, will deliver safe, high-quality care as an alternative to hospital admission, or will support early hospital discharge. The programme will be implemented by early winter.
Discharge without Delay, supported with a further £4 million, will improve pathways through hospital settings, reducing inpatient length of stay and building bed capacity. Working with patients, families and/or carers, it will ensure patients are treated in their home where appropriate.
Health Secretary Humza Yousaf said: “This winter is likely to be the most challenging in the history of the NHS, and it’s important we take urgent action to ensure our hospitals and emergency frontline staff are not overwhelmed. That’s why these actions to improve the discharge process, and redirect patients who don’t need to be in hospital, are so important.
“I am confident that through our collective investment in people, capacity and systems to deliver the right care in the right setting, we can improve outcomes for those of us who need to use our health and social care services.”
The Scottish Government has invested more than £80 million this year to support the reduction in waiting times for people having elective procedures, which has been impacted by the pandemic. To minimise delays for those patients waiting on urgent hospital treatment within four weeks, including cancer patients, extra capacity is being provided through private hospitals over the winter period.
Discharge without Delay launches this month, with four early adopter sites to test the approach, with the aim of rolling the programme out nationally across all sites over the next 10 weeks.
The Interface Care Programme launched this month in two pathfinder sites – NHS Greater Glasgow and Clyde and NHS Tayside. Roll out across all boards is planned over the winter.
