1. Carin van Doorn Chair Congenital Subcommittee
PICU Resources
Carin van Doorn
Chair Congenital Subcommittee

2. PICU access for cardiac surgery
PICU bed availability mandatory to deliver cardiac surgical output
Services standard define minimal activity (by 2021: 500 operations/centre/yr)
Lack of PICU capacity limits output
Most paediatric cardiac units have a shared PICU
Traditionally seasonal variation in PICU access, with less capacity in the Winter – but more recently pressures all year round
National problem of PICU access - increasing difficulties

3. Current situation
PICU historically developed according to regional demand, no national service plan
Access variable across country
Drive to centralisation of children’s services in 90’s has de-skilled local PICU/HDU – low threshold to refer sick children to tertiary centres
10% of children use 90% of capacity

4. National Review of PICU and Specialised Surgery in Children
Aim: develop a sustainable model of care that maintains current high quality services and sustainable and affordable way in the future Paediatric Critical Care in England • Level 1 (acute care) • Level 2 (high dependency advanced care) • Level 3 (intensive care) (n.b. definition of levels of care different from congenital review)
Review involves: - PICU - Transport for children requiring critical care - ECMO - Specialised Paediatric Surgery and Urology
Commenced October 2016
SCTS on Expert stakeholder panel

5. Update of review so far

6. Access to PICU for cardiac surgery
PICU review addresses large problem affecting multiple specialities
SCTS continues to engage with NHS E to help assure adequate access to treat patients with congenital heart disease as the new models for service delivery are developed.