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

2. 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

3. 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

4. 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

5. 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

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

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

8. 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

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

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