31st October 2025

A seriously concerned parent at Colchester Hospital has lodged an urgent escalation regarding the care of their daughter, here referred to as “the child” (to preserve anonymity), who is currently admitted and placed on what the hospital has described as a High Dependency Unit (HDU). Despite this classification, the parent says that monitoring, intervention and response to clinical deterioration fall well below recognised standards — and that this constitutes a serious patient safety concern.

Unacceptably unstable observations, and failure to escalate

The child has recorded repeated episodes of hypotension (blood pressure as low as about 81/45 to 90/50 mmHg) and bradycardia (heart rate of 46-50 bpm over several hours). In addition, she has exhibited seizure-like activity, profound fatigue, and severe unrelieved abdominal pain tied to faecal loading and bowel loop distension (confirmed by an X-ray).
Despite the severity of her condition and the HDU classification, no transfer to a paediatric intensive care unit (PICU) or formal escalation under hospital policy (sometimes known as “Martha’s Rule”) has been initiated. The parent says the deterioration has been ongoing and yet not appropriately escalated.

Inadequate pain and seizure management

According to the parent, staff on duty have explicitly stated that “there is nothing that can be done tonight” in respect of pain control. This was said so the parent could sleep, but this would be impossible with a child in severe pain. Seizure events are reportedly not being actively monitored; the parent claims that when they raise concerns about seizure activity the response is dismissive. Disturbingly, the bedside monitor is said to have been silenced after seizure activity. In this particular child’s case, who lives with autonomic dysfunction and a diagnosis of Ehlers‑Danlos Syndrome, bradycardia — not tachycardia — is well-recognised during distress, making the comment deeply troubling from a clinical-standards perspective.

Failure to provide 1:1 monitoring despite HDU classification

Overnight images provided by the parent depict the child connected to a standard ward monitor, rather than a dedicated HDU monitoring system, and with no consistent bedside presence recorded. The lighting in the ward was dim, and the child appeared visibly in distress and exhausted — signs, the parent argues, of a lack of active supervision in a unit described as “high dependency”. They contend that the environment and care provision fall far short of what should be expected for a Level 2 paediatric HDU under the NHS England guidance for paediatric critical care.

Breaches of statutory regulations

The parent claims the following regulatory breaches:

  • Regulation 12 – Safe Care and Treatment: Ongoing deterioration without appropriate escalation or intervention.
  • Regulation 9 – Person-Centred Care: Failure to make suitable adjustments for a child with complex needs (including autism‐spectrum / neuro-divergent traits).
  • Regulation 13 – Safeguarding Service Users from Abuse and Improper Treatment: Continued exposure of the child to clinical neglect, despite repeated warnings and parental concerns.

Supporting evidence

The parent has submitted:

  • Vital sign records showing persistent low blood pressure and heart rate over hours.
  • Photographic evidence of the ward/monitoring setup, confirming that the care environment did not appear commensurate with HDU standards.
  • Documentation of clinician comments down-playing pain and risk despite abnormal findings.
  • A history of the child’s previous admissions with faecal loading, megarectum and bowel distension — situations that triggered escalation previously but apparently not this time.

Requested actions

The parent is calling for the following immediate steps:

  1. An external clinical review of the child’s current management and safety, ideally by a senior paediatric critical-care specialist.
  2. Formal notification to the hospital’s Critical Care Lead to review whether the child’s care environment meets HDU Level 2 criteria.
  3. Confirmation that the matter is logged as a Patient Safety Incident (PSI) and is being investigated under the duty of candour rules.
  4. A response at Care Quality Commission (CQC) level addressing whether systemic issues exist in paediatric escalation and pain/seizure management at Colchester Hospital.

In short, the parent believes their child has been placed in a unit flagged as “high dependency” yet has received care that appears to fall substantially below expected standards — risking serious harm. They are urgently seeking external oversight and assurance that the child is safe and that appropriate escalation is underway.