In 2015 the newly formed Paediatric Perioperative Care Committee’s mission statement was that “Every child having a GA for a procedure/operation should expect to receive pre-operative assessment that meets the medical, physical and emotional needs of that child”. Since then, there have been significant developments towards that goal.
Initially, growth in the provision pre-assessment services for children was driven by a change in anaesthetic and surgical culture. This demonstrated that children gain significant benefits from a pre-operative assessment service. The Covid pandemic and rising patient waiting lists accelerated pre-operative assessment for children. This is the driver behind the NHS 2023/2024 elective surgery priorities, to set a the requirement for hospitals to provide “a system of early screening, risk assessment and health optimisation for anyone waiting for inpatient surgery”.
Digital platforms that are centred around the patient, their parents or carers offer huge potential to help manage clinical demand and identify areas of intervention that can improve outcomes earlier in streamlined patient pathways. At Birmingham Children’s Hospital we have developed digital screening to triage patients on the waiting list to the most appropriate & effective preoperative assessment pathways. This allows us to optimise the allocation of pre-operative assessment nurses and anaesthetists. We can now identify patient groups earlier, for example those with anxiety, allowing those patients to access resources sooner so they are ready when they are eventually admitted. Our digital assessments are detailed but over 60% of families currently complete it and they describe valuing the process.
Resources such as the children’s and young people’s elective recovery toolkit are excellent. In summary, making time to evaluate how digital services can fit into your patient pre-operative pathways and implement systems to enable this results in significant positive step changes in a perioperative service’s performance.
Dr Barry G Lambert, Consultant Anaesthetist, Birmingham Women’s & Children’s NHS Trust