New Children’s Hospital presentation Suzanne Dempsey, Group Director of Nursing Children’s Hospital Group 20 th June 2015

“There can be no keener revelation of a society's soul than in the way in which it treats its children” Nelson Mandela

Strategy for Child Health Government National Policy & Framework – ‘Better Outcomes, Brighter Futures’: the National Policy Framework for Children and Young People HSE National Clinical Programmes for Paediatrics and Neonatology – a plan for how and where acute paediatric and neonatal services are organised and delivered across the acute hospital system – due for publication Q HSE National Service Plan - Integrated Care Pathway for Children to commence All-island network for congenital cardiac disease 3

Strategy for Child Health Government decision in 2012 on the largest capital investment in health – new children’s hospital and two satellite centres - as a catalyst for an integrated clinical network for paediatrics Children's Hospital Group established in 2013 as one of seven hospital groups: –Remit to integrate the three children’s hospitals in Dublin to become one entity before transitioning to the new facilities –Develop a Strategic Plan to reform paediatric services in greater Dublin area and –Be the client to the capital build 4

Governance approach to service delivery and project delivery Amalgamation of 3 hospitals Corporate / Clinical Governance Service Integration Plan Transfer of services to new hospital Client for the capital project Children's Hospital Group Board (CHGB) ‘The Hospital Group Board’ Chairman Jim Browne Plan Design Build Equip Commission National Paediatric Hospital Development Board (NPHDB) ‘The Development Board’ Chairman Tom Costello

Children's Hospital Group Consists of the three children's hospitals: Our Lady’s Children's Hospital, Crumlin; Temple Street Children’s University Hospital; National Children’s Hospital at Tallaght Hospital Group Board established on an administrative basis, with Ministerial approval given to legally establish the group using primary legislation Academic partnerships with all academic institutions providing paediatric professional education, planning has commenced on this framework to work as an Academic Health Sciences Network New children's hospital is being planned as central to an integrated clinical network for paediatric services on the island of Ireland Smallest hospital group with the biggest change management challenge 6

Children's Hospital Group Highlight metrics: – Clinical Activity: ED - 115,372 In-patients- 25,700 Day care – 27,363 OPD – 180,000 Workforce - 2,891 headcount Total beds Budget - annual allocation €210m All national paediatric specialities based in either OLCHC or TSCUH Significant variability in infrastructure

What is best for children and young people?

3 children’s hospitals Crumlin, Temple Street & Tallaght 3 larger Paeds Units Cork Galway Limerick Belfast – part of all- island Congenital Cardiac Disease Network Acute Paediatric Services Waterford Wexford Kilkenny Portlaoise Mullingar Cavan Drogheda Clonmel Portiuncula Tralee Letterkenny Sligo Castlebar Cork National Model for Paediatrics and Neonatology 20 acute paediatric services

H H H CUH, Temple Street Established Beds (in-pt and day care) 8,200 in-pts, 8,400 day cases Voluntary Hospital Owned by the Sisters of Mercy OLCH, Crumlin Established Beds (in-pt and day care) 10,300 in-pts, 17,500 day cases Voluntary Hospital Owned by the Board of OLCHC NCH at Tallaght Opened 1998-Harcourt St (1821) 66 Beds (in-pt and day care) 7,200 in-pts, 2,900 day cases Voluntary Hospital under Charter for AMNCH Owner by the Minister

What is best for children? Clinical care and treatment needs to be as near the child’s home as clinically appropriate. The vast majority of paediatric services are delivered on a same day basis and delivered locally with less than 22% attending children’s hospitals from outside the greater Dublin area DONEGAL In-patients % Day care % GALWAY In-patients % Day care % CORK In-patients % Day care % LIMERICK In-patients % Day care % Greater Dublin Area Dublin, Meath (part), Kildare, Wicklow In-patient – 78% Day Care – 65%

What is best for children? Saving children’s lives: The sickest children and young people have better clinical outcomes if treated in a hospital that has scale & critical mass: -scale means a high caseload volumes -critical mass means at least 32 clinical specialties and sub-specialties -minimum population of 3.5 – 5 million required to support this level of specialisation in one tertiary children’s hospital -this means all specialties currently in 3 Dublin hospitals being in one hospital -not all sub-specialties are in Paeds, so best co-located with a large adult hospital with a depth & breath of specialties and sub-specialties -tri-location (children / adult / maternity) is the optimal model for sick children and mothers

Tri-location (Paeds/adult/maternity) Mothers Staff Adult Hospital Children’s Hospital Staff Maternity Hospital Adolescents Infants Staff

Vision for children's services -A National Children's Healthcare independent trust that puts children, young people & their families central to its functioning & decision making -An Integrated Care Pathway for Children with the new children's hospital at the centre of an integrated national clinical network linking with paediatric units in regional hospitals, local paediatric services and community / home based services -The configuration of paediatric services within geographically based Hospital Groups and CHOs to support appropriate local access to paediatric services, with outreach support from the Children’s Hospital Group -National paediatric and neonatal ambulance transport and retrieval services to ensure the timely transfer of the sickest infants and children to the most appropriate hospital

-The successful integration of the three children's hospitals into a single organisation before moving to the new hospital facilities -A new state-of-the-art children’s hospital tri-located on a campus with St James’s Hospital and a maternity hospital, opening in 2019, that will provide safe, high quality tertiary / quaternary specialist paediatric services for the island and in conjunction with its satellite centres, provide secondary paediatric services for the greater Dublin area -Satellite centres at Connolly and Tallaght Hospitals to open mid 2017, providing emergency / urgent care and better local access to general paediatric & trauma ortho OPD services, chronic disease management, diagnostics and to support community and home based services -An academic health sciences network to support greater integration of clinical service with education, innovation and research to deliver better health and wellbeing outcomes for children and young people on the island and globally Vision for acute children's services

NEW CHILDREN’S HOSPITAL 473 beds (380 In-patient & 93 day care subject to continuous review) 100% single rooms – with ensuite & family area in each room Advanced diagnostics, intervention and theatre facilities Play areas, external gardens and courtyards Therapy area with hydro pool & gym Hospital School Integration of Research, Innovation, Education & Clinical Services (Children’s Research & Innovation Centre) Parent / family accommodation adjacent to the hospital (Ronald McDonald House Charity) Adequate car parking for families

Satellite Centres: Key Departments Emergency (each 20% activity) 25,000 attendances Outpatients (each 7% activity) 15,000 Child Sexual Assault Unit Education HSE Primary Care Dental Services (Connolly) Imaging (CT shared)

Sat C 2 Medical Home Community Paediatrics Sat C 1 Integrated Care – transition to lower cost settings NCH & CRIC UCC UL UCG 2 o 3 o 4 o CARE 2 o CARE 1 o CARE Model of Care for Paediatrics

Integrated Care – transition to lower cost settings Medical Home GP / CCP / SS Accessibility Care coordination Linked to community based organisations EHR GP / CCP / SS Accessibility Care coordination Linked to community based organisations EHR Clinical Communications Care plans Structured Referrals Optimal Models of Care Disease Specific Care Pathways Structured Referrals IT infrastructure for IP & OP E-prescribing Test and Referral Tracking Electronic Health Record Performance Reporting Quality / Outcomes Finance New hospital 2 Satellites (General Paediatrics & Orthopaediatrics, chronic disease management) New hospital 2 Satellites (General Paediatrics & Orthopaediatrics, chronic disease management) Model of Care for Paediatrics

RESEARCH SOCIAL JUSTICE Patient care Education SOCIAL JUSTICE Education Community Service Global Health Academic Paediatric Medical Centre - Mission Joined up Service and Academia

Thank you