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UK reviews intensive care and emergency services

The British government has promised extra money to fund more paediatric intensive care beds (see also p 654). The announcement came after the report ofan inquiry into the death of a 10 year old boy who was transferred four times by ambulance in less than 12 hours because of shortages in intensive care beds. Nicholas Geldard collapsed at home on 7 December 1995. Health authorities will now be asked to review the working of their emergency services, a national database of intensive care beds will be set up, and new money from an NHS expansion budget of C500m will be used to increase the number of paediatric intensive care beds. The chairman of the inquiry into the death of Nicholas Geldard, Judge Bill Ashworth, said that the case "revealed a curious mix of praiseworthy staff commitment, idiosyncratic call-out arrangements, ghastly misjudgment and insensitivity, and a ponderous bureaucracy which bedevils clinicians who seek paediatric neurosurgical advice." The report said that Nicholas's death was due to a ruptured cerebral artery aneurysm that re-bled after an initial leak. His likelihood of surviving the incident was not altered by the care that he received. The health secretary, Mr Stephen Dorrell, expressed sympathy for the Geldard family and said that the lessons from the case would be learnt. The health department has already published guidelines on admission and discharge criteria for intensive care units. Mr Dorrell called on health authorities to make more use of the intermediate, high dependency beds. While the chief medical officer, Dr Kenneth Cahman, undertakes a broad based review of workforce planning for accident and emergency services, Mr Dorrell has charged the NHS chief executive, Mr Alan Langlands, with the task of reviewing individual health authorities' progress. Speaking after the Commons announcement, Mr Langlands said that responsibility for the workload of intensive care units and