Paediatric and adult intensive care in Britain

Where should paediatric surgery be performed? Commentary Commentary Commentary

“…Better results for diagnosis and treatment of certain high risk or rare childhood disorders can be achieved by concentrating expertise; this has been shown for radiology,37 pathology,38paediatric intensive care,39-42 and neonatal intensive care 43. In many ways the debate these other specialties have regarding centralisation is remarkably similar; Murdoch and Bihari state that “Paediatric intensive care, to function well, must be associated with a full range of on-site paediatric specialties—cardiology, renal, neurology and surgery.”40 The forthcoming Troop report is expected to highlight the benefits of carefully planned paediatric intensive care provision, with centralisation of very high intensity level care. Thus specialist techniques and expensive equipment, such as high frequency oscillation, nitric oxide treatment, and extracorporeal membrane oxygenation can be evaluated and fairly rationed.…”

“…Training is also highlighted as a problem in other allied specialities such as paediatric intensive care40 and anaesthesia 18…”