The Royal College of Surgeons’ report said 21 hospitals provide general paediatric surgery in the country, but 18 others are having problems appointing these doctors.
The issues are highlighted in a new model of care for Ireland, launched yesterday, aiming to address the increasing challenges in this area, including the growing number of doctors who are specialising in particular forms of surgery.
The plan sets out recommendations on how service improvements in providing general paediatric surgery could be achieved. It would designate both regional and local paediatric surgical facilities, with operating procedures suitable for each site.
The key principles include a national network of hospitals providing safe surgical care for children supported by Children’s Health Ireland (CHI), which oversees the three Dublin children’s hospitals.
The aim is that children and families benefit from being able to access appropriate elective and acute surgery, close to home. Regional general paediatric surgeons will decide where surgeries will be delivered.
Children who require transfer to Dublin should be transported in a timely and safe manner with senior surgeons regionally, and with CHI coordinating the transfer. There should be acute surgery for children provided locally in an appropriate environment.
The Royal College of Surgeons said that its training programme for surgeons will include giving them the necessary experience to support the rollout of expertise to regional and local level.
An audit and peer-review process will be developed to assure the quality and safety of care. Complex surgeries will continue to be delivered through CHI, in Dublin. But CHI has indicated capacity issues for general surgery in the new National Children’s Hospital will arise unless a significant proportion of the low acuity operations in the children’s hospitals are redirected back to regional and local hospitals.
Each regional hospital undertaking general paediatric surgery must have one designated lead anaesthesiologist who has a subspecialty interest in paediatric anaesthesia.
Dr Ciara Martin, national clinical adviser and group lead for children and young people in the HSE, said: “It’s important to have a networked approach to surgical care, that is underpinned by national standards and supported training and education for the teams of nurses and doctors delivering care in all of our national hospitals.
“It is important for those delivering care to children and young people, and even more so it means that patients and their families can be confident of the care they receive wherever and whenever they need it.”
Surgeon Ken Mealy, chair of the working group for the general paediatric surgery model of care, and co-lead of the national clinical programme in surgery, said: “There is an emphasis on safety, workforce planning, training and quality assurance of service provision, to ensure that all children who require acute or elective general paediatric surgery are managed in an appropriate environment by staff with the requisite skills.”
