Minister announces 4 additional PICU beds for Crumlin

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All-Island Congenital Heart Disease Network Conference takes place in Dublin

Announcement by Minister Harris of 4 additional PICU beds at Crumlin welcomed

313 children and young people from Northern Ireland have received

treatment in Crumlin since 2015 under this new and innovative model of care

The Minister for Health Simon Harris TD is the keynote speaker at the All-Island Congenital Heart Disease All Island Network Annual Conference, which is being attended by more than 250 delegates in Farmleigh in Dublin today and tomorrow.

The All-Island Congenital Heart Disease All Island Network was established in March 2015, and is the first clinical network of its kind, providing an all-island service surpassing politics and borders*. The Network manages an all-island service delivery model for congenital heart disease in children, building on existing services and drawing them together in a network of care which is patient focused and locally responsive.

Now, all emergency and urgent paediatric cardiac surgery for children and young people on the island of Ireland takes place in Our Lady’s Children’s Hospital, Crumlin (OLCHC). In the last year, 9 patients from Northern Ireland requiring emergency or urgent paediatric cardiac surgery, who otherwise would have had to be transferred to Great Britain, were treated at Crumlin. This year, 18 elective surgical patients were treated there.

At the Conference, the Minister for Health Simon Harris TD announced that the construction of a 4-bed extension at the Critical Care Unit in Crumlin has been jointly approved by the Departments of Health North and South, which will support the expansion and enhancement of services being delivered by the Network.

A number of other imminent Network developments were also marked by delegates at the Conference today, including:

  • A new extension to the Clark Clinic, Royal Belfast Hospital for Sick Children, Belfast, with the new Cardiac Outpatient Department due to open on Tuesday, November 6th 2018;

  • The network is currently recruiting a number of paediatricians with a special interest in cardiology to hospitals in Cork, Craigavon, Galway, Derry and Limerick – ensuring all children will be treated as close to home as is clinically appropriate;

  • The Network will shortly be recruiting two Professors of Paediatric Cardiology, one North and one South of the border;

Speaking at the Conference, Minister for Health Simon Harris TD said; “I am delighted to be able to announce that a further milestone in the development of the network has been achieved. Both Departments of Health have now formally approved the construction of the four-bed extension to the paediatric intensive care unit in Crumlin. This extension will allow for the expansion and enhancement of the services offered by the Network, benefitting more children and young people on the island of Ireland”.

Chairman of the All-Island Congenital Heart Disease All Island Network, Dr Len O’Hagan said; “It’s emotionally, psychologically, physically and financially draining for a family from Northern Ireland to have to travel to Great Britain for cardiac treatment and the aim of the Network is that in time, when our programme of work is fully implemented, for the vast majority of children and families**, this will not be necessary. We have made significant progress already in the last 3 years, and with the announcement of these additional 4 beds at Crumlin by Minister Harris today, and his continued in the future  for the commitments made by Minister Varadkar and Minister Wells in 2016 to the Network, we will be able to do even more.

“The network consists of hundreds of people, from surgeons to family members who have proved that the love of their children surpassed politics and borders. They are role models for all citizens, north and south, working together to deliver what really matters on our small island,” he said.

Dr Paul Oslizlok, Paediatric Cardiologist at Our Lady’s Children’s Hospital, Crumlin and Clinical Network Lead in the Republic of Ireland, said; “Working with our colleagues in Northern Ireland, we are changing the way congenital heart disease is treated on the island of Ireland. The patient is at the centre of this new mode of care.  Ultimately their experience, and clinical outcome, is the driver of all that we are doing.”

Professor Frank Casey, Paediatric Cardiologist at Royal Belfast Hospital for Sick Children and clinical lead in Northern Ireland, said, “We are committed to working with colleagues across the island of Ireland to continue to improve clinical care and outcomes for patients north and south. Our collective, whole effort is greater than the sum of its parts,” he said.

Margaret Rogers, Heart Children Ireland said; From Heart Children Ireland’s point of view, this news that four new PICU beds will become available shortly is welcome. We have advocated for a world class centre of excellence for many years. This investment is another step on the road to ensuring as far as possible that no families will have to travel outside Ireland to access treatment.

We would urge continued investment in specialised staff to ensure the speedy opening of these new PICU beds.”

Katherine McDonald, interim CEO of Children's Heartbeat Trust said: “The announcement today of the four additional PICU beds in Crumlin to support the All-Island children’s cardiology network, is really welcome news. Every year, between 130 and 150 children with heart conditions from Northern Ireland have to travel to hospitals in either Birmingham or London for planned surgery. This adds a huge amount of stress to what is already a very difficult situation for families. With families sometimes away for weeks at a time, the impact can be significant. Today’s announcement brings us a great deal closer to children from Northern Ireland with heart disease being able to access the full range of care they need on the island.” 

Ends
The following are a number of achievements made by the Network since its establishment in 2015.
  1. A new extension to the Clark Clinic, Royal Belfast Hospital for Sick Children, Belfast with the new Cardiac out-patient department due to open on Tuesday next.
  2. All emergency and urgent paediatric cardiac surgery now takes place in OLCHC, and 2018 saw the commencing of the transfer of some elective surgical patients. (approx. 40 of 120 NI patients who undergo cardiac surgery per annum). The remaining 80 children will continue travel to Great Britain for their surgery until the additional PICU beds at OLCHC are approved & completed.  (Expecting an announcement from the Minister on Friday giving approval to proceed with the additional beds at OLCHC.)
  3. A weekly North South telemedicine case conference to review and plan for surgical paediatric CHD patients on the island.
    A new hybrid catheterisation laboratory opened in 2015 in OLCHC and now facilitates an all island service with a single waiting list and all procedures across the island being carried out at OLCHC.
    The network is appointing Paediatricians with a special interest in Cardiology to the hospitals at Cork , Craigavon, Galway, Derry and Limerick meeting our commitment that all children should be treated as close as possible to their homes.
    Two research professorships (Professor of Paediatric Cardiology) are about to be advertised one North and one South.
    Common Clinical standards across both jurisdictions have been agreed by the Network Clinical Advisory Group and are being implemented.
    Shared educational programmes have been developed attended by Nurses across both jurisdictions.
  4. A review of the repatriation services for NI families of deceased children following cardiac surgery in Great Britain carried out IN 2018. 6 recommendations approved by the Network Board and Submitted to the NI DoH.
**Children who require transplant will still need to travel to GB – There are no Paediatric transplant services in NI / ROI.
* Background on the All-Island Congenital Heart Disease All Island Network:
On the 14th of October 2014, a joint policy statement was published by the Minister for Health and Social Services in Northern Ireland, Jim Wells, and the Minister for Health in the Republic of Ireland, Leo Varadkar, referencing the expert International Working Group (IWG) report on the Assessment of Cardiology and Cardiac Surgery for Congenital Heart Disease in Northern Ireland and the Republic of Ireland. The report made clear and explicit recommendations on the development of a single congenital cardiac service for Northern Ireland and the Republic of Ireland, thus establishing the All-Island Congenital Heart Disease Network. A total of 14 recommendations were presented which together form the IWG’s proposed model for a service that would meet the needs of the entire population with congenital cardiac conditions, whether adult or child, in Northern Ireland and the Republic of Ireland.
Phase one set out the requirement for all paediatric surgical and cardiac catheterisation cases for the island of Ireland to be performed at Our Lady’s Children’s Hospital, Crumlin (OLCHC) with a phased increase in capacity at OLCHC to absorb the additional volume. Approximately 150-160 children with congenital heart disease are referred per year for cardiac surgery in Northern Ireland, and these patients will be managed and cared for in a shared-care model with medical care being delivered in the Royal Belfast Hospital for Sick Children and surgical care at OLCHC. All cardiac catheterisation cases that had been performed in Northern Ireland were subsequently to be undertaken at OLCHC. The establishment of a cross-border collaborative implementation commission enabled the work to commence on increasing capacity and resources to accommodate the integration of services from Northern Ireland.
Surgery and interventional procedures are only two elements of a complex network of services for children with congenital heart disease that begins with prenatal screening and continues through to the transfer to adult services. It is recognised that children and families are entitled to local access for as much other cardiac-related care as is safe and appropriate. The All-Island Congenital Heart Disease Network has set about Phase 2, the establishment of Paediatric Cardiology Peripheral Services in keeping with the National Model of Care for Paediatric Healthcare Services in Ireland, the NI Strategy for Child Health, the NHS Congenital Heart Disease Standards and Specifications, underpinned by the vision and mission of the CHD Network.
The All-Island CHD Network was established with the purpose of providing a framework of governance to facilitate the work required and recognise the cross-jurisdictional responsibilities, following Ministerial acceptance of the recommendations of the International Working Group (IWG). The All Island CHD Network manages the all-island service delivery model, building on existing services and drawing them together in a network of care which is service user focused and locally responsive. The basic concepts of the network are of partnership, service integration and formal arrangements, defined as linked groups of health professionals and organisations from primary, secondary and tertiary care, working in a co-ordinated manner, to ensure equitable provision of a high quality, clinically effective service.