The provision of general paediatric surgery (GPS) is said to be reaching a crisis but there is little data indicating the support provided to peripheral units by paediatric surgeons based in tertiary centers. A survey was performed to obtain this information noting changes in provision over a ten-year period.
BAPS members from all 26 tertiary centres in the UK were contacted by telephone, e-mail or directly in 2007 and again in 2017. Each centre was asked to provide details of the number of outreach clinics or theatre lists performed in local peripheral units per week. Data was analysed with an on-line statistical package performing paired t-tests.
A complete dataset was obtained from all twenty-six centres, representing 100% of tertiary units in the UK. In 2007 these centres provided a weekly total of 49.25 clinics (Mean 1.89 SD 1.39) and 26.25 operating lists (Mean 1 SD 1.29) in 122 peripheral units. In 2017 a weekly total of 96.55 clinics (Mean 3.74 SD 3.06) and 58.25 operating lists (Mean 2.24 SD 2.40) were provided in 127 peripheral units.
In 2007 all but one tertiary centre in the UK provided outreach clinics and 69% provided outreach surgery. In 2017 two tertiary centres did not provide outreach clinics and 73% provided outreach operating lists.
This represents a significant increase in peripheral support for clinics (p = 0.002) and operating lists (p = 0.001) between 2007 and 2017 and represents an average increased workload per centre of 2 to 4 clinics/week and 1 to 2 operating lists/week.
This survey demonstrates that tertiary units in the UK are providing significant outreach GPS with a doubling of clinical support provided by tertiary units between 2007 and 2017.
These changes in provision of services are essential information for commissioning GPS.