Many health professionals treating children in the NHS do not have the latest training and information on a number of vital issues, a report has warned.
According to the Healthcare Commission, trusts are failing to pass on advances in basic training surrounding paediatric resuscitation, pain management and child protection.
The study found 29% of trusts did not regularly update staff training on child protection.
A staggering 74% of trusts were found to have an insufficient number of staff trained in specialist paediatric life support, while 11% had got worse since the Commission's last report in 2005/06.
And surgeons and anaesthetists were also losing their skills, with 63% of trusts failing to ensure the professionals were doing the recommended number of operations on children to maintain their training.
Only 59% of trusts could boost the basic level of one nurse per shift in emergency and day care wards trained to manage children's pain.
The report's authors wrote: "It is of great concern that the findings from the follow-up review show a consistently low level in the uptake of training in paediatric life support among key staff, while a high proportion of surgeons and anaesthetists carrying out procedures on children still need to have more work experience to properly maintain their specific skills."
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