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Network solution to child surgery shortfall

15 July 2010

Surgery for children faces a future skills crisis with sick children facing unnecessary delays for operations or travelling long distances for routine surgery unless co-ordinated action is taken now by the surgical profession and the NHS, warns the Royal College of Surgeons. New guidance published today (Thursday, July 15th 2010) by the Children’s Surgical Forum calls for the establishment of new networks across NHS boundaries to provide routine surgical services for children in local hospitals.

Su-Anna Boddy, Consultant paediatric urologist and Chair of the Children’s Surgical Forum, said: “Sick children should not have to face long journeys or delays for relatively straightforward operations which, until recently, would have been available at their local hospital. General operations like hernia repairs, ochidopexy (undescended testicles) or draining abscesses are now increasingly being diverted to specialist paediatric units which exist to treat the most ill children or those with rare conditions requiring specialist surgery. These units are now completely snowed under and are struggling to cope. This guidance offers practical solutions for delivering efficient paediatric surgical services and we urge every NHS Trust to consider working with us to put this into practice.”

Children account for nearly 25 per cent of the UK population, and with such a large patient population it is vital that routine surgical and anaesthetic care can be delivered from local hospitals. Traditionally, operations on children were carried out by the same general surgeons and urologists who treated adults, but the numbers have dwindled due to retirement, while surgical training has become increasingly focused on specialist paediatric surgery for rare and childhood-specific conditions. In fact, no general surgery trainees have undertaken the optional general paediatric surgery exams in past years.

In addition, many NHS Trusts have failed to prioritise paediatric surgical services. Newly advertised consultant positions for general surgeons or urologists do not encourage applicants with an interest or experience in children’s surgery. Excess bureaucracy, such as repeat criminal records checking, has also made it difficult for paediatric surgeons to travel and operate where they are needed, resulting in patients having to travel to them.

The new guidance, Ensuring the provision of general paediatric surgery in the district general hospital, aims to turn this situation around by proposing NHS commissioners, Trusts and specialist units work together formally to set standards, share skills and ensure patients get treated in the most appropriate hospitals.

Dr Carol Ewing, Royal College of Paediatrics & Child Health Workforce Officer and Lead for Paediatric Surgery, said: “The Royal College of Paediatrics and Child Health welcomes this report which we have worked on with the RCS to produce. Surgery for children is an essential component of high quality services and we strongly support the delivery of paediatric surgery through managed clinical networks. A joined up approach is crucial to successful implementation of the reports recommendations and we look forward to how commissioners, service planners and Trust providers intend to do this.”

The guidance is available to download on the RCS website.



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Notes to Editors
1.    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
2.    If you have any queries please contact:
Matthew Worrall     – Email:; T: 020 7869 6047
Elaine Towell        – Email:; T: 020 7869 6045
Heather Casey       - Email:; T: 020 7869 6042
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