Paediatric Surgical Services Is there a Scottish Way?

Paediatric Surgical Services

Is there a Scottish Way?

PlanBackground

Issues

Bending the ear of those in government

Future

Background

Two Scottish Surgical Colleges

RCA – Scottish Advisory Board

AAGBI - Scottish Standing Committee

What forum is there for paediatric issues in Scotland?

A bit of vision

1997

A surgical Chief Medical Officer and a Professor of Paediatric Surgery

Acute Services Review

Treatment Services for Children included recommending child centred services

An unwieldy name

Scottish College’s Committee for Children’s Surgical Services

The committee will constitute a collective voice for Children’s Surgical practice in Scotland, providing advice to the Colleges and SGHD on matters concerning service delivery, quality assurance and, if required, the manpower implications of training.

SCCCSSAvoid political association

Need for substance

Involve all the Royal Colleges

All specialties represented

Paeds surgery, orthopaedics, ENT, neuro, cardiac, ophthalmology,

Plus anaesthesia, ICU, nursing, radiology, emergency medicine, paediatric medicine

SCCCSSBut also

Representative of the CMONSDGeneral surgical (DGH) rep

Six monthly meetingsOpportunity for round table discussion of issues

relevant to paediatric practice

Sounds like something else?

Children’s Surgical Forum?

“it appears that the concerns in England and Wales are very similar to those raised through this group.’

Minutes of SCCCSS Dec 2005

SCCCSS was first!

What has it done for Scottish Children?

General

Designation of Health Board members with responsibility for children

Workforce planning

2007

Key Issues Manpower

Standards

Service Delivery

Age

Priority

What has it done for Scottish Children?

General

Designation of Health Board members with responsibility for children

Workforce planning

New tertiary children’s hospitals

What has it done for Scottish Children?

General

Designation of Health Board members with responsibility for children

Workforce planning

Standards for care of children in District General Hospitals

2010

Support of Specialist Services for Children and Young People within a District General Hospital

What has it done for Scottish Children?

General

Designation of Health Board members with responsibility for children

Workforce planning

Standards for care of children in District General Hospitals

New tertiary children’s hospitals

Aberdeen 2004

Glasgow 2015ish

Edinburgh 2017ish

Aberdeen 2015ish

What has it done for Scottish Children?

Surgical

Reviews ofGeneral surgery of childhoodPaediatric neurosurgeryRenal transplantation servicesCleft lip and palate

Surgical Outcomes

2009

An early attempt at providing measurable and meaningful quality outcome indicators for paediatric practice

Anaesthetic involvement Initially tertiary, DGH and ICU rep appointed by RCA

Notable involvement David Simpson Neil Morton Jane Peutrell

APA representation stems from then -2007

Currently three anaesthetic reps RCA – G Wilson (Hon Sec) APA – Carolyn Smith SPAN – John Rutherford

Anaesthetic SpecificSPICA

PICU retrieval service - SCOTSTAR

HDU audit and allocation of funds from the National Delivery Plan

Continued support for delivery of non-specialist services

Communicating with Government

Mutual respect

Interface with decision makers – early interaction with National Clinical Lead for Children’s and Young People’s Health

Senior Medical Officer attends

Medical Director of NSD

Future

Representation

Finance

Awareness

Formalisation of Advisory Role

SCCCSS has stayed away from this as it risks extending the role beyond the remit of the organisation

The Scottish Government has ultimate responsibility and takes advice from SCCCSS on this

Finance

Currently funded by College of Surgeons jointly

Limiting but liberating!

Awareness

Limited knowledge of committee existence

Minutes distributed to Colleges only

Should they be more publicly available?