LAUSR

Background Clinical Networks are formed by Network Centres (NC) and Lead Specialist Centres (LSC) for Gastroenterology and Nutrition to provide high quality, specialist care to the local population. According to the Quality Standards released by RCPCH and BSPGHAN, by definition Network Centres have at least one Consultant Paediatrician with a Special Interest in (SPIN) Paediatric Gastroenterology. It is important to understand the layout of service availability in secondary care and its uniformity across the United Kingdom (UK) to ensure delivery of high-quality care. Objectives There is scarcity of information about the secondary care network for Paediatric Gastroenterology in the UK. The primary aim of the project was to quantify the secondary care trusts with at least one General Paediatrician with a Special Interest in Gastroenterology and comprehend how these specialists are distributed across the UK. Secondly, we aimed to look at the support these hospitals receive from Lead Specialist Centres in the form of outreach clinics. Finally, the last goal was to map the Paediatric Gastroenterology Clinical Networks in the UK. Methods The list of hospitals providing Paediatric services in the UK was collected from the National Health Care systems’ and Paediatric deaneries’ websites for England, Wales, Northern Ireland and Scotland. We identified a number of centres providing Paediatric secondary and tertiary care services, and subsequently contacted them via telephone or e-mail. All the data was collected from Paediatric Doctors (Specialty Registrars or Consultants), Specialist Nurses or Secretaries working in Paediatrics over the period of one year, through standard verbal questionnaire or electronic survey. Results We identified a total of 153 secondary care trusts providing specialist services to the Paediatric population across the UK. Approximately 62.7% of these centres had at least one Consultant Paediatrician with SPIN in Gastroenterology. The region with the largest percentage of secondary centres with SPIN doctors was KSS (Kent, Surrey, Sussex) with 91.7%, followed by Scotland with 83.3%. On the other hand, Northern Ireland and the North West of England had the lowest percentages. Southampton, Chelsea and Westminster and Bristol are the LSC which provide the highest number of outreach support. However, nearly a 1/3 of the LSC in the UK do not provide any outreach clinics. Discussion/Conclusion The results of this pioneering project highlight the wide variance in availability of SPIN doctors and outreach clinics in different regions across the UK. The lack of significant correlation amongst different analysed variables may suggest that this variability is secondary to unquantifiable factors such as geographical reach/constraints, intent and local funding policies. We believe this information is valuable to local, regional and national service commissioning groups in the redirection of efforts and resources to target populations where more urgent intervention is required. Points can be learnt from the top performing regions to improve delivery and establish uniformity of care. This project not only identifies the need for continued work in this domain, but also provides a foundation and structure for further analysis of the current services offered in secondary care.