Children and Young People’s Health Support Group National Steering Group for Specialist Children’s Services in Scotland General Surgery for Children Project Group

Drivers National Framework for Service Change – decision to review child health services including a review of general surgery Why? Changing workforce Very few general surgeons undertaking paediatric surgical training Changing referral patterns Changes in supporting infrastructure Definitive standards of care / National Reports e.g. Kennedy Age appropriate care

Review Aims An overview of current emergency and elective service provision Optimise local care delivery depending on age and case complexity Ensure there is equity of care throughout Scotland Identify the necessary resources to maintain service model To define regional networks of care with defined levels of care in each DGH and onward referral pathways

Review Remit To undertake a review of current patterns of general surgical care To formulate and recommend care pathways To consider solutions for those areas which most challenge services To evaluate implications for families and associated specialities To produce a report for consultation with relevant groups Timescale - One year July 2006 – July 2007

Review Process Questionnaire to determine: Staffing profile Paediatric Facilities Ability to treat certain tracer conditions Associated speciality support Circulate to hospitals who deal with children

Review Process Questionnaire Selected visits Forth Valley Dumfries Ayrshire Lanarkshire Tayside Highland

Aim to Define Surgical speciality profile Anaesthetic service profile Nursing profile Theatre team support Medical paediatric support Diagnostic support – radiology ; laboratories ; pathology “Paediatric Environment”

Speciality Support 1. Paediatric Anaesthesia 2. Associated Speciality Obligate component of training Option period of extended training Supportive and ongoing CPD 2. Associated Speciality Orthopaedics; ENT; Ophthalmology/ Plastics / Dentistry Paediatric Practice included in training BUT 3. Outlier = General Surgery 4. Very few general surgeons undertaking paediatric surgical training

Summary Kerr Report Delivering for Health “Local Care for acute and common conditions - when appropriate and safe care can best be delivered

Summary Now Local workforce determines service configuration Needs Design Service Model then: Define Recruit Retain