Children’s hospital care model changed

ORIGINAL plans for the manner in which care will be delivered at a new children’s hospital have been significantly changed according to the board of directors of Our Lady’s Hospital for Sick Children in Crumlin (OLCHC).

The board said it believes the experts commissioned by the Health Service Executive (HSE) to draw up a framework brief for the development of the new National Tertiary Paediatric Hospital (NTPH) are planning on splitting services over a number of sites.

This would include substantial day care and outpatient care and up to six operating theatres at two satellite facilities. A third satellite facility would provide non-consultant-led assessments and care or referral for unplanned presentations, but would not have operating theatres or dedicated diagnostic resources.

The board said it believed the emerging model of care proposal “has departed significantly” from the original concept as outlined by McKinsey.

McKinsey, the consultants originally employed by the HSE to examine international best practice in tertiary paediatric services, said urgent care centres outside the main hospital were an option, but these should not have inpatient children’s beds.

Crumlin’s concerns that the original proposals are changing were raised following a meeting between the Crumlin board and RKW, the consultants drawing up the framework brief.

“We are particularly concerned with the potential of this proposal for duplication and fragmentation of services, thus stretching scarce consultant and specialist nursing resources unnecessarily,” the board said.

“It appears to be a more dispersed model of care than we have, when the first goal of the exercise was consolidation and concentration,” the board added.

The board also expressed concern that simultaneous construction of the NTPH and a co-located maternity hospital is not being considered.

“Co-location of children’s and maternity/neonatal services is, in our opinion, a non-negotiable re-configuration priority. We note that the details of the maternity/neonatal development do not form part of the framework brief,” the board said.

It also expressed concerns that workforce planning had not been addressed. “For example, existing consultants currently work across two hospital sites. Increasing this to three sites or more would adversely impact on the ability of the NTPH to deliver complex children’s services,” the board said.

Last night a spokesperson for the HSE said work was ongoing in the preparation of the framework brief and “it is too early to speculate on its content”.

OLCHC is committed to the consolidation of tertiary paediatric services — currently there are three children’s hospital in Dublin — but is opposed to building the new hospital on the Mater campus.