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This house believes that all children should be anaesthetised in a Children’s Hospital

This house believes that all children should be anaesthetised in a Children’s Hospital. Dr Charles Ralston Consultant Anaesthetist Birmingham Children’s Hospital. Why ? Moral obligation Essential to sustain DGH integrity It’s fun Professionally necessary Economic sense.

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This house believes that all children should be anaesthetised in a Children’s Hospital

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  1. This house believes that all children should be anaesthetised in a Children’s Hospital Dr Charles Ralston Consultant Anaesthetist Birmingham Children’s Hospital

  2. Why ? • Moral obligation • Essential to sustain DGH integrity • It’s fun • Professionally necessary • Economic sense

  3. We pay taxes to maintain locally available services ……..

  4. Emergency service is unviable without Paediatric Anaesthesia ………………………

  5. We need to have paediatric –based competency…………

  6. Children are fun ……………………………………. (especially when they are asleep)

  7. Why Not? FEAR of Failing of Disaster of Criticism of Litigation

  8. “COMPETENCE” • NCEPOD 1989 Lunn’s recommendations Guidelines, guidelines, guidelines • FRAMEWORK FOR THE FUTURE 1997 ………………………WHY BOTHER?!

  9. What Is Competence ? Evidence None Intuition More Is Better

  10. COMPETENCE OF THE SYSTEM Agree a standard Measure achievement Improve Measure again …………………. (eg Standards for WMIDS – critically ill and injured children related anaesthetic standards)

  11. What is to be done? • Collaborate • Combine surgical service provision • Single multidisciplinary team • Develop team and system competence

  12. How ? • Reduce surgical hegemony • Agree operating policies and protocols…………………………….For the system • Training packages • Multidisciplinary audit and governance • Regular specialist input – organised outreach ! SUSTAINABLE and SAFE

  13. Politics • Public account deficit • PCT Clusters Reconfiguration Quality Cost savings Safety Public choice

  14. Disadvantages None

  15. CONSIDER ALL CASES BCH • 1.3 Million (under 19) – 2009 Census • 250,000 in Birmingham BCH - 13000 GA’s / Annum - 55% activity from B’ham PCTs - 7000 cases ALL REFERRALS = INCREASE OF 28,000 CASES/ANNUM

  16. Implications • 36 More operating theatres 300 More theatre staff 20,000 Hours coffee break per week • All suture packs end to end - stretch to the moon and back • 16 More orthopaedic surgeons

  17. PAEDIATRIC ANAESTHESIA SHOULD AND MUST BE PROVIDED IN OUR DGHs !!!

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