A new model of care for the sustainable delivery of paediatric general surgery in Ireland has been launched today by the National Clinical Programme in Surgery (NCPS) and the National Clinical Programme for Paediatrics and Neonatology (NCPP&N).

The model was developed as part of a collaboration between the Health Service Executive (HSE), the Royal College of Surgeons in Ireland (RCSI), the Royal College of Physicians of Ireland (RCPI) and a national network of hospitals providing surgical care for children supported by Children’s Health Ireland.

Paediatric General Surgery: A Model of Care for Ireland 2024, announced today at RCSI, outlines a comprehensive framework to enhance surgical services for children close to where they live, ensuring access to a high standard of surgical care with clear oversight and governance.

The new model addresses the growing challenges faced by the paediatric surgical community, including the increasing specialisation of surgical practices and the recruitment of general surgeons who can deliver paediatric care. Without intervention, these challenges could impact access to local or regional general paediatric surgical care for children in the future. 

The model of care sets out recommendations on how service improvements in the provision of general paediatric surgery could be achieved with the designation of both regional paediatric surgical facilities and local paediatric surgical facilities, outlining operative procedures appropriate for each site. 

The framework aligns with the Sláintecare principles of treating patients closer to home, whenever possible. Complex surgeries will continue to be delivered through Children’s Health Ireland in Dublin. 

Safe, high-quality care

Speaking at the launch, Mr 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: “Today's launch represents a significant step forward in ensuring that every child in Ireland has access to safe, high-quality surgical care, no matter where they live. This model of care has 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.” 

Professor Deborah McNamara, President of RCSI, said: “This model of care will support the delivery of excellence in paediatric general surgery in Ireland and drive improvements in policy and practice for the benefit of patients and their families. I look forward to seeing the implementation of the recommendations of the framework, which represents the commitment of the paediatric surgical and medical community to providing a sustainable, equitable system of care for children in the future.”

Dr Ciara Martin, National Clinical Advisor and Group lead for Children and Young People, HSE said: “Having 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 is important. 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.”

The key principles of the model of care are:

• A national network of hospitals provides safe surgical care for children supported by Children’s Health Ireland 
• Children and families benefit from being able to access appropriate elective and acute surgery close to home
• Regional general paediatric surgeons decide where surgeries will be delivered, i.e.:   
  -Children who require transfer to Children’s Health Ireland (CHI) in Dublin are transferred in a timely and safe manner with senior surgeons regionally and in CHI coordinating the transfer.
  -Acute surgery for children provided locally occurs in an appropriate environment.
• RCSI incorporates appropriate paediatric surgical experience within the general surgery training programme supporting general paediatric surgery workforce planning for the regional and local general surgery paediatric units.
• An audit and peer review process are developed to assure the quality and safety of care. 

Paediatric General Surgery: A model of care for Ireland 2024 can be downloaded from the publications section of the NCPS's online resources.