Life and death on Royal Bolton Hospital's children's ward (2022)

“When they hit the big red button on the wall, it was like something off the TV.

“We just broke down.”

Daniel Gregory pauses as he recalls the moment he thought he would lose his baby boy.

His son James was placed on a liver transplant list on Christmas Eve after falling gravely ill.

He was just five-months-old.

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The tot was to spend the next 181 days living in hospital enduring countless surgeries and treatments.

His heartbroken parents had no idea whether their only child would pull through.

But his life was saved when a desperate Facebook appeal prompted a donor to come forward.

His journey is just one of the incredible stories to come out of the paediatric ward at Royal Bolton Hospital.

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The Manchester Evening News was given an exclusive access visit to the ward to see how NHS staff care for children across the region.

Alarm bells first started to ring when James attended a baby sensory class with his mother Becci, Daniel says.

Another parent commented on how his skin tone appeared different to the other children.

At two-months-old, James was taken to his GP and referred to Bolton Royal Hospital.

The tot underwent blood samples and scans before then being transferred to Leeds.

There, he was diagnosed with biliary atresia, a rare condition in newborns.

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The disease means the common bile duct between the liver and the small intestine is either blocked or missing.

Early surgery is seen as critical to prevent irreversible liver damage.

Once the liver fails, a liver transplant is required.

James was sent for a seven-hour Paediatric Kasai Procedure to allow the bile to drain.

But with the operation being only 33 per cent effective, James’ parents received the news they were dreading.

He would need a liver transplant.

As the family waited for a suitable donor, James’ condition deteriorated rapidly. Eventually he developed sepsis.

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“A nurse came in and tried to get a reaction out of James by pulling his legs,” Daniel, a 33-year-old builder, says.

“He didn’t react so they pressed the big red button on the wall. It was like something off the TV.

“We just broke down. Up to that point, it never entered my head that we could lose him. It just didn’t.

“When that happened, I thought we were going to lose him. That’s when it really hit.

“I'm not saying Bolton staff took extra care for James, but we felt like they did.

“That's how all the doctors and nurses made us feel. You feel that extra special - you feel like they're your sister or your best friend.”

When little James eventually recovered, his parents issued a social media appeal to find him a liver.

The post went viral and the hospital was inundated with calls.

After 73 days on the transplant list, a donor was found and James had his life-saving surgery.

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After spending the majority of his life in hospital, he is now healthy and living at home with his family in Radcliffe.

But not all families get their happily ever after.

Andy Butler, a matron at Royal Bolton Hospital, says there are certain tragedies that have stayed with staff on the ward.

“We had to withdraw care on a child that had cancer,” he recalls.

“It was his birthday at the weekend and his parents wanted to take him home.

“He just wasn’t going to make it. It was heartbreaking, really.”

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Andy commutes 90 miles from Ulverston in Cumbria to Bolton for work almost every day.

He previously cared for patients on the Intensive Care Unit where he sometimes saw the “worst-case scenarios”.

But his love for his job and working with the “best medical team” is what gets him through.

“You don’t become used to it,” he continues. “You become a little bit hardened to it at times.

“Those are just little snippets of the worst cases. In general, kids get better and go home with a smile on their face.

“I've been at Bolton for five years and that's mainly down to the team.

“They're the best medical team I have ever worked with and I've been qualified for 25 years.”

Dr Ian Freeman, a consultant paediatrician at Royal Bolton Hospital, says one of the most challenging parts of the job is remaining strong for parents during traumatic events.

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Working on one of the busiest children’s wards in Greater Manchester, staff care for those aged up to 16.

The ward sees up to seven thousand children a year.

Dr Freeman says: “It can be quite emotive and stressful at times.

“It’s a very rewarding job. The majority of the children that we see get better, which is great.

“It’s amazing how quickly children will recover.

“I suppose for those children where they don’t that can be particularly difficult where children die if they are very sick.

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“And of course, you’re not just dealing with a child. You’re dealing with the parents as well.

“Dealing with the parents can be difficult because it’s such a traumatic event.

“We can be very emotional and upset at times dealing with those sorts of situations.

“Afterwards it can be difficult for staff, that's why we try and have debriefs after those events.

“But you have to be professional. You have to remain level-headed and calm in those situations and be strong for the parents.”

And it’s not just the Acute Paediatrics ward where help is offered to loved ones.

Bolton NHS Foundation Trust offers services for children with learning disabilities.

The trust also provides integrated community children’s services, health visiting, school nursing, healthy families service, adolescent health, paediatric learning disability service, paediatric speech and language therapy, and more, from a number of health centres across Bolton.

Brinley Yates, who has learning disabilities, is a regular user of the service.

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The service helps assess the 15-year-old, implementing behaviour management strategies to best support and meet his emotional and physical health needs.

The Children’s Learning Disabilities team have specialist knowledge and work with children and young people to identify what support they need and create a plan of care.

Brinley, from the Harwood area of Bolton, says: “I have lovely visits.

“Me and Claire (the caregiver) have lovely laughs.

“We talk about happy things and anxiety.

“It’s been a hard year for isolation. I couldn’t see family members.

“I enjoy my time with (care staff) because I can talk about recent days.”

Brinley’s mother, Dianne, says the service has been a huge help for her and her family.

“Without the service –- I don’t even want to think about it,” the 48-year-old tells the Manchester Evening News .

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“I feel like I’ve got my Brinley back now to what he was pre-Covid. It was absolutely dreadful.

“It’s having someone to share his emotions with because he can’t readily do that.

“It was very difficult throughout Covid. Knowing I had the service is what got me through.

“I just felt so alone and didn’t have anyone to talk to.”

The Trust’s community based children’s services often work together, and closely with other professionals such as education and social care to provide a co-ordinated approach to caring for children in Bolton.

Matron Andy Butler, who qualified as a nurse more than 20 years ago, says the rewards of the job help balance out the tragedies on the ward.

“With nursing, particularly in ICU, when someone has died, it’s all very respectful,” he continues.

“Then there’s another child that’s sick and needs your care and you’re the one that needs to step into gear and crack on with it.

“You remember the sad and the happier stories.

“But the rewards far, far outweigh the sadness.”

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