Desperately ill, this baby girl is being driven to London in an 85mph race for life

A tear runs down the face of a sick baby as doctors struggle to insert a nasal tube to take over her breathing.

Thirteen-month-old Penelope Berry, anaesthetised and covered in wires, is being prepared for transfer to a paediatric intensive care unit in London.

Spotting her distress, Dr Shelley Riphagen, lead consultant in charge of the transfer, orders more anaesthetic and advises a local medic how to place the tube.

Forty-eight minutes after the transfer team’s arrival, Penelope is in an ambulance travelling at up to 85mph through rush-hour traffic to St George’s hospital in Tooting.

This is the South Thames Retrieval Service in action. The little-known service will perform about 1,000 such transfers this year, taking critically ill children from 20 district general hospitals across south London, Kent, Sussex and Surrey to specialist care, mainly at Evelina London, King’s College or St George’s hospitals.

The request to transfer Penelope had come from the Royal County Surrey Hospital in Guildford. The baby, who had one lung clogged with pneumonia, had twice been admitted to intensive care in two months and was again struggling to breathe.

She was taking 70 breaths a minute — an adult takes 15 to 20 — and was at risk of respiratory failure within hours, said Dr Maeve O’Connor, a member of the retrieval team.

The Guildford medics had prepared the baby for transfer but had struggled to intubate her. “They are not used to seeing children at that level of their illness,” the team’s nursing sister, Natalie McErlain, said. Yesterday Penelope was said to be doing well at St George’s.

The South Thames Retrieval Service is based at Evelina, alongside St Thomas’ hospital in Lambeth, and draws its staff from Evelina’s paediatric intensive care specialists.

Come the winter peak, it can expect to receive up to a dozen calls a day. Transfers such as the one from Guildford will be routine.

Dr Riphagen said: “That is a normal day at work for me. That child was critically ill and needed to move out of there as fast as possible. It’s about supporting the local team to help them do that.

“As a parent, you want the best care delivered to your child by the best team in the right place at the right time. It’s about making sure that happens for all children, no matter where they are.”

The service, the first in the UK when it founded 20 years ago, costs about £3 million a year to run.

It carried out 953 inter-hospital transfers last year across a patch extending from Worthing to Margate. Two teams are available 24 hours a day. About 40 to 50 per cent of cases involve respiratory conditions, such as asthma or bronchiolitis. Neurological conditions such as meningitis and encephalitis account for about 25 per cent. Cardiac patients and children with sepsis make up much of the remainder.

A similar service, Children’s Acute Transport Service, operates north of the Thames and in the northern Home Counties, taking patients primarily to Great Ormond Street, St Mary’s and the Royal Brompton.

On rare occasions, the pressure on London’s 100 paediatric intensive care beds is so great that transfers have to be made “out of region”. Staff recalled one night last winter when two patients were taken from Margate to Southampton. There was also a transfer to Oxford and one to Sheffield last December. In previous years, children have been taken to Newcastle and Liverpool.

Normally, however, space for south Thames patients is found at Evelina, which has 19 beds, even if it means putting two children in one bed space.

This winter there is concern of a flu epidemic. The first cases of bronchiolitis, a respiratory infection affecting young children, have begun. To cope with winter pressures, Evelina cancels training courses, restricts leave and avoids non-emergency surgery. Winter funds are being used to speed the “repatriation” of recovering patients to their local hospital to free-up Evelina beds. The team also provides advice to enable children to stay in their local hospital.

The use of such specialist teams has helped achieve a reduction in child mortality from 11 per cent to four per cent, putting the UK on a par with other leading nations. The Brompton has said that its paediatric intensive care unit, which has 20 beds, would be forced to close if NHS England proceeds with plans to remove congenital heart surgery from the hospital. NHS England has indicated the beds would be opened elsewhere. Dr O’Connor, who was on her first call-out after switching from Children’s Acute Transport Service, said: “It’s an incredible service. I think the UK is really lucky to have something like this.”