10/4/2015 Norfolk and Norwich University Hospital NHS Foundation Trust 1 The organisation and future...

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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The organisation and future of paediatric surgical services

Kathy Wilkinson

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Change in location of surgery for children

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Why have these changes occurred ?

• Changes in the surgical population

• Changes in practice have resulted in a reduction in some common operations e.g. tonsillectomy, grommets, circumcision

• Training, competencies and confidence

• Our attitude to risk and our ability to treat children requiring surgery may have changed

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Copyright ©2008 BMJ Publishing Group Ltd.

Field, D. J et al. BMJ 2008;336:1221-1223

The changing paediatric surgical population

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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• Fewer routine ENT procedures• Increased laparoscopic surgery• Increased endoscopies• Increased number of radiology

cases

Changes in medical and surgical practice

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Paediatric surgical practice in England 2008-9

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Where do children have surgery? NCEPOD 2011

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Workload

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Do we have the complete picture?

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Assessment of care

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Deaths-Age and gender

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Deaths-Diagnostic group

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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UK has a relatively high child mortality

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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How long does transfer take?

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Assessment of care

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Obstacles to safe paediatric practice?

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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Networks

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SWACASWACA WACAWACA SEPAPSEPAP

PAGWPAGW

OxfordOxford

PAN WMPAN WM

NW PAGNW PAG

East Anglia Network

East Anglia Network

NENESPANSPAN

THAMESPAG

THAMESPAG

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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The new NHS in England…

04/19/23 Norfolk and Norwich University Hospital NHS Foundation Trust

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CYPHOF

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Other drivers

• See Back to the Future 2 (RCPCH April 2013)

• Audit of 10 key paediatric standards

• Results of this and further workforce planning may result in further closure IP paediatric beds

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Why can’t we have this sort of detail in rest of UK?

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2013CSF standards

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Some snippets

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Specialist services…