Delivering Ireland's New Children's Hospital

Joint Statement from the Children’s Hospital Group; the National Paediatric Hospital Development Board; Our Lady’s Children’s Hospital, Crumlin; Temple Street Children’s University Hospital; the National Children’s Hospital, Tallaght and St. James’s Hospital

June 22, 2016: We are unequivocal in our certainty that the campus at St. James’s Hospital is the right location for Ireland’s much needed and much wanted new children’s hospital. Sharing a campus with St. James’s Hospital will deliver better clinical outcomes and improved survival rates for the sickest children and young people.  Collectively we are committed to delivering a state of the art children’s hospital and to providing the right care and services, in the right location, by the right team, for local children and for Ireland’s most vulnerable children and young people. Much of the infrastructure of the three Dublin children’s hospitals does not allow us to provide the best possible care, as services are on three different locations in Dublin, and this is a source of great daily frustration for all the committed staff working in paediatric services.

There are many reasons why the campus shared with St James’s Hospital is the right location for the new children’s hospital, but the primary one is that it has the greatest number of clinical specialties that will best support our teams in the delivery of better services and clinical outcomes for our sickest children and young people.

This critical level of clinical support is not available at Connolly Hospital.

It is recognised international best practice from a clinical perspective to locate children’s hospitals on the same campus as an adult teaching hospital with the breadth and depth of specialities to support complex paediatric services and a maternity hospital that provides service for high risk mothers and babies – this is known as tri-location. The tri-location of these three hospitals – the new children’s hospital, St James’s Hospital and in time the relocated Coombe Women & Infants University Hospital – will create a campus of unrivalled clinical expertise to support highly specialist service delivery, research, innovation and education.

The staff of the three children’s hospitals, families, children and young people, as well as, children’s health and advocacy groups and the faculties of paediatrics have been campaigning for a new children’s hospital for decades. Following a long and detailed planning process, more than 1,000 hours of engagement with all stakeholders, and a comprehensive oral hearing in December, An Bord Pleanála granted planning permission for the development of the new children’s hospital on a campus shared with St. James’s Hospital.

Clinical considerations and improving survival rates amongst the sickest children have, and remain to be, at the forefront of all decisions in relation to the new children’s hospital project. However, the practical needs of families and children are also being planned and catered for in great detail by the Development Board, the staff of the three children’s hospitals and the St James’s Hospital team, who are all working tirelessly together to make this long awaited project a reality.

Construction work for the first phase of the project is scheduled to commence within a matter of weeks.

We want to continue to reassure all families, children and young people that our ability to deliver the best possible care and improved outcomes for sick children will be enhanced once the new children’s hospital, located on a campus shared with St. James’s Hospital, is completed. We look forward to serving the needs of children, young people and families in this new children’s hospital for generations to come.

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Why St James’s Hospital is the best adult co-location partner for the new children’s hospital

 

  • St James’s Hospital has the widest range of adult sub-specialities that can support paediatric services, ensuring patients with conditions whose prevalence does not warrant paediatric-only consultants, get the best support.  For example, St James’s Hospital is home to the national Radiation Oncology (cancer) department and the Irish Blood Transfusion Service Board.
  • Synergies between adult and paediatric: Co-location with St James’s Hospital ensures access for children to adult specialists in conditions which are more common in adults. Joint management of these conditions by specialists who work with both children and adults provides better quality of clinical care to the children and young people concerned. Examples include cardiac surgery, ophthalmology, plastic surgery, ENT, burns and maxillofacial surgery. In Ireland, because of our population these cases are better managed by those surgical specialists who work with both adults and children, as they can develop and maintain their skills through their work with the greater number of adult patients and they can apply the skill and expertise to the case of children and young people with similar issues. (It is likely to be some decades before the new children’s hospital has a fully individual consultant staff, and this may never be practical (given our population) for some specialities.) There are many clinicians that are working between St James’s Hospital and the children’s hospitals already (in areas such as immunology, haematology, plastic surgery, dermatology, radiation oncology and maxillofacial surgery), and this will increase once the new children’s hospital opens. Having them on the same campus will lead to inevitable efficiencies, as currently, consultants have to travel between the hospitals for appointments.
  • A model for transition to adult services for children and young people with chronic conditions will also be best served from co-location with St James’s Hospital. Examples of this include cystic fibrosis, arthritis, epilepsy, gynaecological disorders, chronic skin conditions and immunodeficiency’s.
  • Research: Research will play a central part at the new children’s hospital. ‘Today’s research is tomorrow’s cures’.  St James’s Hospital is one of Ireland’s leading research hospitals. It has an excellent, internationally recognised, clinical, research and education culture and infrastructure.  The new Children’s Research and Innovation Centre and the provision for active research within the hospital and on the wider campus, will foster the type of research intensive environment that is required on a campus of healthcare excellence.
  • Attracting and retaining the best staff: The new children’s hospital will be a world-class facility, custom built to deliver the best care and treatments that are available. It was recognised in the McKinsey Report that co-locating with an adult teaching hospital facilitates clinical and academic ‘cross- fertilization’, helping to attract and retain top staff.
  • Economies of scale: Co-locating with St James’s Hospital will mean that the new children’s hospital will have access to highly specialised equipment that it would not otherwise have access to. An example of this is a PET scanner; St James’s Hospital is the only adult hospital in Dublin to have a public PET scanner.

 

Addressing some Myths

Connolly Hospital

Planning permission has been granted to build a Paediatric Urgent Care and OPD Satellite Centre at Connolly Hospital which will meet the day to day needs of children local to that area. (Permission has also been granted for a Satellite Centre at Tallaght Hospital for children local to that area).

However, Connolly Hospital does not have the range and right type of clinical specialities and sub-specialties required to support the new children’s hospital. Hundreds of millions of euro and many years of capital and HR investment would be required to bring it to the necessary level before it could be considered medically appropriate as a co-location alternative, not to mention a reconfiguration of services across all the leading Dublin teaching hospitals. To continue suggesting that it is an appropriate alternative is erroneous and misleading.

Claims that the new children’s hospital could be developed at Connolly Hospital” quicker and cheaper” are not true. No costings have been considered for an alternative site, however, the inevitable much longer timeline which would ensue –  and construction inflation – would be expected to have a significant impact on project costs and this, together with expenditure on the project to date, would exceed any hypothetical savings that supposedly could be obtained from building on a greenfield site. Recommencing the planning process would also mean that construction on the hospital would not commence until 2019 / 2020 – at the earliest – which is when the new children’s hospital on a shared campus with St James’s Hospital will be near completion.

Aside from the clinical reasons – which are paramount – neither does the site at Connolly Hospital have the correct and necessary supporting infrastructure.

 

Parking for families

Claims that very sick children will be asked to use the Luas / public transport are completely unfounded. The reality is that the new children’s hospital on a campus shared with St. James’s Hospital will have three times more car parking spaces than what is currently available at the existing three children’s hospitals. 675 car parking spaces will be dedicated to families and families will be able to reserve parking spaces in advance.

Importantly, the repeated claim that there would be more/unlimited parking at Connolly Hospital is unfounded and this was confirmed by An Bord Pleanála in its report when it said: “There is a flaw, in my opinion, in the argument put forward by some of those who advocate a greenfield site adjacent to the M50. They appear to assume that unfettered access off the national and primary route and unfettered access to on-site car parking can be accommodated. The same national, regional and local transportation policies are equally applicable at that location as they are at the application site and do not support such a strategy.”

 

Room for Expansion

The new children’s hospital has been designed to meet projected child population growth and unmet clinical need. The campus at St James’s Hospital has in excess of 50 acres of land. 12 acres are being made available for the new children’s hospital and the site has been designed for future expansion. The new children’s hospital design is based on meticulous healthcare planning which will result in a facility which can provide for very significant expansion (25-30%) in delivery of healthcare.  Beyond this, a further 20% expansion capacity has been identified outside of the current building footprint.

 

Caption for image:

Pictured at the celebratory event marking the granting of planning permission for the new children’s hospital in at Our Lady’s Children’s Hospital, Crumlin in April were Lorcan Birthistle, CEO, St. James’s Hospital, David Slevin, CEO the National Children’s Hospital, Tallaght, Eilish Hardiman, Chief Executive, Children’s Hospital Group,  the then Minister for Health Leo Varadkar TD, CEO of Our Lady’s Children’s Hospital, Crumlin  Helen Shortt,  Chief Executive, Temple Street Children’s University Hospital Mona Baker, Project Director, NPHDB John Pollock.