The Child Health Clinical Outcome Review Programme delivered by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has released Right Place, Right Time, Right Team, examining the care of children and young people undergoing non-elective surgery. The findings reveal significant progress in some areas but also highlight critical gaps that need attention.
Key Findings:
- Timely Access: Over 92% of patients reached the admitting hospital without delay but 15% experienced surgical delays due to team availability
- Network Support: While 84% of hospitals are part of emergency surgery networks, around 10% remain outside these arrangements, potentially impacting thousands of patients
- Staff Confidence: Centralisation of elective paediatric surgery has reduced confidence among some clinicians in non-specialist units
- Fasting Concerns: 17% of patients were fasted longer than clinically necessary risking discomfort and harm.
Recommendations:
- Strengthen specialist networks and ensure timely transfer pathways
- Guarantee access to appropriately trained paediatric surgeons and anaesthetists
- Introduce emergency theatre coordinators to reduce delays
- Implement daily theatre capacity reviews
- Adopt protocols to minimise unnecessary fasting.
These recommendations aim to improve safety, reduce delays and enhance patient experience across the perioperative pathway. For perioperative leaders the report underscores the importance of robust networks, clear escalation processes and consistent standards of care.