16 May 2008
By the time babies born today reach school age there may not be enough surgeons able to treat them unless swift action is taken by the Department of Health, the medical profession and NHS Trusts. This is the conclusion of a new survey conducted by the Association of Surgeons of Great Britain and Ireland (ASGBI) of General Paediatric Surgery (GPS) to be debated at their International Surgical Congress on Friday May 16.
In recent decades, surgery for children has focused on specialist centres to enable specialists to provide the best outcomes for complex conditions and neonatal cases. But, increasingly, even the most routine surgery for children has also been diverted to these centres with families facing long journeys seeking basic care for their children.
This, in turn, has placed career opportunities for GPS services in local hospitals under threat and, as a generation of general surgeons with skills in treating children start to retire, the situation is only going to deteriorate.
The key findings of the GPS survey*, which gained a 100 per cent return rate, are:
- Currently 23,000 elective paediatric cases a year are dealt with by surgeons in local hospitals –specialist centres do not have the physical capacity or workforce to take on this caseload.
- There has been a 30 per cent drift of GPS away from district general hospitals over a decade (Cochrane & Tanner report).
- One third of acute NHS hospitals in England, Wales and Northern Ireland do not provide GPS at all.
- There is a window of opportunity to stimulate training - 68 per cent of the hospitals that do provide GPS can continue for 5-10 years – but many are worried about the future.
“There is unanimity across surgery that this is a looming problem and one we need to settle now if we are to avoid serious shortcomings in the care of future generations of children,” says survey author Jonathan Pye, Honorary Secretary of the Association of Surgeons of Great Britain and Ireland (ASGBI). “There is a great swathe of basic care that, with the right support, could be delivered locally. The answer requires a concerted effort from the medical profession and NHS management – renewed training, Trusts advertising local GPS posts and regional networks to ensure best practice is spread.”
“We support the local provision of general paediatric surgery in district general hospitals and, consequent to the decreased involvement of consultant general surgeons, specialist paediatric surgeons now provide 46 clinics and 20 operating lists in local hospitals weekly in the UK**,” said Richard Stewart, Honorary Secretary of the British Association of Paediatric Surgeons. “But this has occurred without planning and we strongly recommend the involvement of strategic health authorities working with local trusts, surgeons (both adult and paediatric), anaesthetists and parents to plan the future provision of this service. There is no one correct solution, but the Department of Health must compel SHAs and NHS Trusts to provide a solution that will work in their region – at the moment this is not happening.”
The annual International Surgical Congress is a major surgical science conference hosted each year by the ASGBI (the association that represents general surgeons) and is held this year between 14th and 16th May at Bournemouth.
Notes to Editors
- * JK Pye, Survey of general paediatric surgery provision in England, Wales and Northern Ireland; Annals of Royal College of Surgeons of England 2008; 90: 193-197.
- ** RJ Stewart, Survey of Regional Networks for the provision of General Paediatric Surgery in the UK, Children’s Surgical Forum newsletter.
- The Association of Surgeons of Great Britain and Ireland (ASGBI) is an association representing general surgery and all its related specialities throughout the United Kingdom and Ireland.
- The British Association of Paediatric Surgeons (BAPS) was founded in 1953. Its objects are the advancement of study, practice and research in paediatric surgery to cultivate professional relations with paediatric surgeons
- The Royal College of Surgeons of England is committed to enabling surgeons to achieve and maintain the highest standards of surgical practice and patient care. Registered charity number: 212808. For more information please visit www.rcseng.ac.uk
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