EXCLUSIVE: Long wait for child-saving training at an end for NHS Orkney’s emergency department staff

Long-running calls for life-saving training to be provided at NHS Orkney appear to now have been heard.

Sources have told The Orcadian about frustration among medical staff with some senior management at The Balfour.

One area of concern has been the lack of advanced life-saving training for child patients in the emergency department.

The problem was flagged by government inspectors in July, who called for improvements to be made.

In response to questions from The Orcadian, NHS Orkney has now confirmed that “a cohort of relevant clinical staff” have been picked to receive the advanced paediatric life support training.

There are no paediatricians on-site at The Balfour, with young patients who require high-level care being transported to NHS Grampian as soon as possible. In Orkney, their care is led by clinicians with the most relevant skills.

Gaps in life-support training at The Balfour have been a long-running problem, according to one consultant who told The Orcadian this was a source of deep concern for staff.

“This shouldn’t ever have been allowed to happen,” they added.

The consultant claimed the authority had “sailed close to the wind a number of times” in terms of serious risks to young patients.

Internal documents from NHS Orkney reveal that calls to improve training in the emergency department have been made for at least two years — and some recommendations are yet to be carried out.

A review was launched in 2024 after “a number of complaints” about patient care in the department were made early in 2023.

To carry out the review, the health board brought in Dr John Thomson — a consultant in emergency medicine at NHS Grampian and previous vice president of the Royal College of Emergency Medicine.

His report, finished in late 2024, has been obtained by The Orcadian following a Freedom of Information (FOI) request.

Dr Thomson praised the work of staff in the emergency department, but also made a number of recommendations — including about providing paediatric training.

His report said NHS Orkney has “a very committed, enthusiastic” team who are focused on delivering the best care for their patients. The department as a whole was “performing well against national standards.”

However, Dr Thomson also highlighted gaps in personnel, training and governance. He homed in on risks caused due to there being “no senior clinical presence” in the department.

The report also flagged that “no one is formally trained in the care of paediatrics.”

Better access to training was one of the six recommendations made by the NHS Grampian consultant.

Dr Thomson said that one way to address “many if not all of the issues highlighted” would be to appoint a consultant in emergency medicine.

Two years on, the consultant who spoke to The Orcadian claimed that no improvements came about following the peer review.

An inspection in March, this year, highlighted the lack of specialist paediatric training in the emergency department once again.

In their report, published in July, Healthcare Improvement Scotland said no medical staff in the department had qualifications for advanced paediatric life support.

For nurses, 60 per cent working in the department had immediate paediatric life support training.

The inspectors called on NHS Orkney to ensure that one staff member was on duty at all times with the advanced qualification.

The consultant who spoke to The Orcadian said senior management have been aware of the gaps in training for years.

They said: “They’re not even trying. Everything seems to be about finances. Nothing is about the patients.”

Another NHS Orkney source also expressed their frustration at the lack of progress.

“We’re very good at having meetings and short life working groups, and nothing happening from them,” they said.

When The Orcadian put questions to NHS Orkney last week, it seemed improvements might be on the horizon, with some staff in line for the training.

Medical director Dr Anna Lamont said: “NHS Orkney is committed to ensuring that staff have the skills, training and support required to deliver safe and effective care for children and young people who attend our emergency department.

“The need for additional paediatric emergency care training has been considered through our ongoing quality improvement work, including actions arising from the 2026 Healthcare Improvement Scotland review.

“As part of this work, a cohort of relevant clinical staff has been identified for Advanced Paediatric Life Support (APLS) training which includes all emergency nurse practitioners and all eleven doctors employed by NHS Orkney that work in the emergency department to ensure there will always be clinical staff on site with advanced paediatric life support training.

“We are working on dates for this training and arrangements will be taken forward to deliver this.”

Dr Lamont said the findings of reviews and audits are routinely considered, and that it was not accurate to suggest no action has been taken.

“A range of improvement work has and continues to be progressed across urgent and unscheduled care services, including workforce development, training, clinical governance, senior staffing, and service delivery.

“We are in the midst of consulting with staff on an updated model for urgent and unscheduled care, and this is expected to lead to a new model of senior supervision that works best for Orkney.”

She added: “Patient safety remains our highest priority. We continually review our services, training requirements and clinical governance arrangements to support the delivery of safe, effective care for the people of Orkney.”

The Orcadian asked NHS Orkney why no consultant in emergency medicine had been appointed, following the recommendation in the 2024 review. We did not receive a response to this question.

The newspaper approached the Royal College of Emergency Medicine, but the organisation said it couldn’t comment on individual trusts or hospitals.