Carin van Doorn Chair Congenital Subcommittee PICU Resources Carin van Doorn Chair Congenital Subcommittee

PICU access for cardiac surgery PICU bed availability mandatory to deliver cardiac surgical output Services standard define minimal activity (by 2021: 500 operations/centre/yr) Lack of PICU capacity limits output Most paediatric cardiac units have a shared PICU Traditionally seasonal variation in PICU access, with less capacity in the Winter – but more recently pressures all year round National problem of PICU access - increasing difficulties

Current situation PICU historically developed according to regional demand, no national service plan Access variable across country Drive to centralisation of children’s services in 90’s has de-skilled local PICU/HDU – low threshold to refer sick children to tertiary centres 10% of children use 90% of capacity

National Review of PICU and Specialised Surgery in Children Aim: develop a sustainable model of care that maintains current high quality services and sustainable and affordable way in the future Paediatric Critical Care in England • Level 1 (acute care) • Level 2 (high dependency advanced care) • Level 3 (intensive care) (n.b. definition of levels of care different from congenital review) Review involves: - PICU - Transport for children requiring critical care - ECMO - Specialised Paediatric Surgery and Urology Commenced October 2016 SCTS on Expert stakeholder panel

Update of review so far

Access to PICU for cardiac surgery PICU review addresses large problem affecting multiple specialities SCTS continues to engage with NHS E to help assure adequate access to treat patients with congenital heart disease as the new models for service delivery are developed.