The paediatric A&E at the Royal Free, in Hampstead, will close at the end of the month. The children’s casualty unit at University College London Hospital, in Bloomsbury, will remain closed, having initially shut to under 18s in March.
It is not known when they will reopen but the closures are said to be “temporary”. The Royal Free and UCLH have been designated as “surge sites” for the feared second wave of covid patients.
Sick children and young people will be redirected several miles away to the Whittington, in Archway, or North Middlesex, in Edmonton – both of which will have their units expanded. Barnet hospital will also accept children.
If a child arrives at the Royal Free or UCLH they will be assessed by specialist nursing teams but will not be admitted to a ward. They may be redirected to other services or, if an emergency admission is required, will be taken by ambulance to another hospital.
If a child is unconscious or not breathing, they will be resuscitated and stabilised before being transferred.
London Ambulance Service will know in advance not to take children to either hospital.
Caroline Clarke, chief executive of the Royal Free London NHS trust, told its board that the changes were “clinically led”. She said: “It’s all about keeping that service safe and going through the winter.”
The changes, which have attracted controversy, have been instigated after a review found that “staffing levels are a challenge to being able to maintain safe and resilient services for children and young people” and recommended running paediatric services in fewer hospitals across north London.
During the first peak, the Royal Free’s children’s department remained open but the paediatric A&E at Barnet was closed.
The Royal Free is also aiming to double adult intensive care capacity, with as much of the hospital kept “covid free” as possible.
There is also the intention to keep Chase Farm hospital, in Enfield, which does not have an A&E, “covid secure” to enable non-covid treatments to continue.
Kate Slemeck, chief executive of the Royal Free, said the aim was for it to increase from 48 intensive care beds to 60-65 but “we could surge well beyond that with additional capacity”. An “uptick” in ICU admissions is expected by “late November”, she said.
The Royal Free’s children and young people's inpatient beds will also close. UCLH specialist inpatient and day-case services, including cancer haemato-oncology and complex adolescents, will remain open.
Great Ormond Street Hospital will provide more room for urgent elective inpatient and some – but not all – day surgery.