The Paediatric Spinal Taskforce has welcomed the news that a number of international outsourcing initiatives have been finalised for children waiting on spinal surgeries.
It said that while this option was not suitable for all children waiting on spinal surgeries, dozens of children and families would be able to avail of the option to get their surgery in world-class facilities. These include Morgan Stanley Children’s Hospital in New York and Great Ormond Street Hospital in London.
The Taskforce said it had been told that Minister for Health Stephen Donnelly flew to the United States to meet with the spinal team, including surgeons and nurses, in Morgan Stanley Children’s Hospital and to finalise arrangements for patients and families who decide to travel for their surgeries. He was accompanied by the head of the Paediatric Spinal Management Unit, Mr David Moore.
The Minister also visited a second hospital but discussions with that hospital remained at an early stage.
The Taskforce said these international collaborations were requested by patient advocates. They were being put in place while capacity continued to be expanded at Children’s Health Ireland (CHI) and aimed to help reduce waiting times. There had been a large increase in referrals for this service and in the level of demand for care.
“Surgeons from New York will be travelling to Ireland shortly to meet with patients who are suitable for, and interested in, travelling to get their procedures done more quickly.
“Following a clinic that was already held in Dublin by surgeons from Great Ormond Street, a number of patients have now been offered treatment abroad in that hospital.
“These are significant developments for children who are waiting on surgery and their families. It was confirmed at the Taskforce meeting that a process will be put in place to ensure families are fully supported in accessing these pathways if it is the right option for their children.
“This package will include flights and accommodation. It is important that surgeons, and the Spinal Management Unit at CHI, is now given the time and space to relay details directly to families who may be interested in availing of these international options. “
The Minister for Health is now chairing monthly meetings with CHI aimed at improving waiting lists and finalising a new operational plan. Additional national outsourcing initiatives are being implemented at the National Orthopaedic Hospital Cappagh (NOHC), the Blackrock Clinic, and the NTPF, which is helping to co-ordinate national outsourcing opportunities for both spinal and non-spinal paediatric orthopaedic patients. These initiatives aim to free up capacity for more complex spinal surgeries at CHI. An NTPF-funded initiative is already in place to improve access to diagnostic MRI under GA (general anaesthetic) for these children.
CHI is implementing an extended operating theatre day to increase the number of procedures that are being carried out at CHI. At the request of the Minister for Health, CHI has also ringfenced a theatre for spinal surgery to ensure these patients receive priority access. Non-complex orthopaedic work is being re-directed away from spinal surgeons at CHI so that our expert spinal surgeons can concentrate on children who need spinal procedures.
Spinal Outpatient Clinics
An out-patient spinal initiative is currently in progress, with the aim of seeing 240 new spinal outpatient referrals across six additional mega clinics by the end of September. These are in addition to the patients who would be seen at existing clinics. To date, four clinics have been undertaken, with 168 new spinal referral patients seen. A further two clinics are being scheduled.
Transitional Adolescent Scoliosis Surgery Service:
Work is underway to commence the transition of adolescents over 16 years of age to the Mater Misericordiae University Hospital (MMUH). This aims to free up surgeons working in CHI to concentrate on children.
Community Supports:
Families had previously highlighted difficulties in accessing aids, appliances and assistive technology to support daily living. All families on the Paediatric Spinal Waiting List have been linked in with a dedicated liaison within their local region to inform them of, and assist with, the supports available.
Paediatric Spinal Surgery Management Unit:
The dedicated Paediatric Spinal Surgery Management Unit, led by Mr David Moore, was established at the request of the Minister earlier this year. This Unit is coordinating spinal services across CHI hospitals as well as working with colleagues in other hospitals to implement strategies to drive continuous improvement and address any challenges within the service.
Taskforce Chair Mark Connaughton said, “A priority focus for the Taskforce in recent weeks has been on improving communications with patients and stakeholders, as families and their advocates said we need to do better on this. The Taskforce was pleased to endorse a new CHI Communications Plan for Spinal Surgery Services which was developed in close collaboration with the advocates, clinicians and service managers on the Taskforce. I am pleased that we have made rapid progress on this important area, and look forward to moving swiftly to implementation so that patients and their voices are better heard and involved, including through the establishment of a new patient panel.”
Minister for Health Stephen Donnelly said, “I’d like to acknowledge the significant progress made. I believe the work that is being carried out by the new Spinal Management Unit at CHI and the Taskforce will make a real difference to children. I was hugely impressed with the hospital I visited in New York. It is a world-class hospital, as is Great Ormond Street. I have made it clear to CHI that we must build our own capacity in Ireland and increase the number of surgeries that are being carried out to meet the demand. This is happening and I have worked closely with Mr David Moore and the Interim Chief Executive of CHI. A new operational plan will be brought to Cabinet in September and this will detail a significant, and rapid, fall in the number of patients waiting longer than four months for their care. I also welcome the development of a new communications plan under the auspices of the Taskforce. This has been a source of great frustration to patients. It is very important that patients and their voices will be at the heart of this work through a new patient panel which will be closely involved in developing and improving communications, including to families, in the future.”
There was a 30% increase in additions to the spinal fusion surgery list in 2022 compared to 2018 and a 42% increase in 2023 compared to 2018 for example.
In 2023, there was a 13% reduction in the number of patients waiting longer than four months for surgery. The number of patients waiting longer than four months for surgery has fallen slightly this year. (from 78 to 76).
