Related Experiment Video
Updated: Dec 31, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Trends in the delivery of elective general paediatric surgery
1Queen's Medical Centre, Nottingham, UK.
Insights
The number of general paediatric surgery cases performed by adult surgeons in England decreased by 34% between 2009 and 2017. Specialist paediatric surgeons saw a 21% increase in workload, largely due to orchidopexy procedures.
Area of Science:
- Paediatric Surgery
- Surgical Workforce Analysis
- Healthcare Service Delivery
Background:
- Clinical networks are crucial for paediatric surgery due to declining adult surgeon involvement.
- Limited contemporary data exists to quantify shifts in paediatric surgical workload.
- This study analyzes the patterns of general paediatric surgery delivery in England.
Purpose of the Study:
- To document and quantify patterns in the delivery of general paediatric surgery in England.
- To identify where and by whom paediatric surgical procedures are being performed.
- To analyze trends in the paediatric surgical workload between 2009 and 2017.
Main Methods:
- Utilized the Surgical Workload Outcome Database for hospital-level data from 2009-2017.
- Included elective general paediatric surgery cases for patients under 18 in NHS hospitals.
- Employed paired t-tests for statistical analysis via an online package.
Main Results:
- Overall elective general paediatric surgical cases remained stable, but the case mix shifted.
- Cases performed by adult surgeons decreased by 34% (4699 to 3090).
- Cases performed by specialist paediatric surgeons increased by 21% (8184 to 9862), with 78% of this increase attributed to orchidopexy.
Conclusions:
- Significant shifts in general paediatric surgical workload are evident.
- Specialist paediatric surgeons experienced a substantial increase in workload.
- Monitoring these trends is vital for service configuration and succession planning in paediatric surgery.
Introduction:
There has been regular dialogue regarding the importance of developing clinical networks to compensate for the steady decline in general paediatric surgery performed by adult surgeons. Despite this dialogue, there are no contemporary published data to quantify the issue. This report documents patterns in delivery of general paediatric surgery in England and shows what is being performed where and by whom.
Materials And Methods:
Using the Surgical Workload Outcome Database, we compared hospital-level data between 2009 and 2017. Inclusion criteria were children under 18 years admitted to NHS hospitals in England for elective general paediatric surgery. Data were analysed with an online statistical package performing paired t-tests.
Results:
There was no real change in the overall number of elective general paediatric surgical marker cases, but the type mix has changed. The number of marker cases performed by adult surgeons fell by 34% (4699 vs 3090 p < 0.05). The number of marker cases performed by specialist paediatric surgeons increased by 21% (8184 vs 9862 p < 0.05). This increase in workload occurred in both tertiary (21% increase) and peripheral (18% increase) centres. When analysing data by operation type it was apparent that 78% of the increased workload was attributable to an increase in orchidopexy rate.
Conclusion:
Best practice is to treat children close to home by staff with the right skills. This study shows significant shifts in the general paediatric surgical workload. It is important to monitor these trends for successful succession planning as well as configuration of services.
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:30Current Trends in Nursing II