Dr Hilary Cass: We must ensure paediatric units provide the right service for children


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Children, like all patients, are entitled to the best medical care when they fall ill. As a children's doctor, I want and expect all children to be seen quickly and assessed properly, and I know every parent wants their child to be treated by doctors and nurses who have expertise in specific conditions.

The way that children's hospital services are currently arranged means that we're in danger of not providing children with the highest possible standard of healthcare. At the moment there are a large number of small units providing general care, but too few providing specialist services, meaning that not all children get the best specialist treatment.

That's why the Royal College of Paediatrics and Child Health has set 10 minimum standards that all paediatric units should meet in order to provide the best healthcare for children. In some cases this means some services have to close and others merge to form larger, specialist units. Fewer, larger specialist paediatric units would have the best medical equipment and the best doctors who have been highly trained to specialise in specific children's medical conditions.

There may be hard decisions for doctors, managers, planners and local people when they have to decide a local service needs to close, but it's crucial to have the right service, even if it is further away, than the wrong service situated on your doorstep.

These kinds of decisions have now been made for children's heart services across England and Wales. The Safe and Sustainable review, which looks at the best options for delivering high quality care for children with congenital heart disease, has had to decide which centres currently providing children's heart surgery will become children's cardiology centres. The aim is to ensure children receive high standards of expert ongoing care closer to home, and those children who need an operation, receive care from a larger dedicated surgical team specialising in their condition.

Having fewer specialist centres would mean that everyone involved in a child's healthcare (from their GP and clinicians at their local hospital to the surgeons and cardiologists at the surgical centre) communicates with one another efficiently so the child's treatment is better co-ordinated. It will also mean that families receive appropriate advice and support from other clinical experts.

I understand that some parents will have concerns about sometimes travelling that extra distance for surgery, but I am confident that these changes will greatly improve healthcare for patients because children will be assessed and treated quickly by specialist doctors. The decisions that have been made today will ultimately save lives by ensuring children with congenital heart disease and those born in future years benefit from better healthcare.

Dr Hilary Cass is President of The Royal College of Paediatrics and Child Health

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