Urgent Care-an untested model

Two Children’s Urgent Care Centres (UCCs) are planned for Dublin. They are not Emergency Departments (EDs). Serious questions remain about the “stand alone” children’s UCC on the grounds of Connolly Hospital in Blanchardstown – its safety, its appropriateness and its operational cost.

Run by Children’s Health Ireland(CHI) and independent of the adjacent adult hospital it is based on no clear model. Though presented to An Bord Plean├íla (ABP) in 2015 as a model, the PANDA unit in the Royal Salford Hospital in England is not comparable – the PANDA unit beside an adult Emergency Department in an adult hospital, accepts all levels of clinical acuity, is continuously open and has a maximum 23 hour stay. The only other models presented to ABP were American and are in essence out -of -hours evening and weekend services open when family primary care paediatricians (equivalent to Irish General practitioners) are off duty.

Due to open in 2020, the UCC currently being built at Tallaght hospital will replace that hospital’s 24 hour Children’s Emergency Department. Depriving the Tallaght catchment area of a 24 hour children’s ED can scarcely be described as a better local service.

The only external review of the New Children’s Hospital project ever commissioned, The National Paediatric Hospital Independent Review, 2011 (https://health.gov.ie/wp-content/uploads/2014//NPH_NACHRI_CHIEF_Review.pdf) , recommended (p12) that “there should be consideration of extending the UCC to a 24 hour service with an appropriate number (between 6 to 8) of 23-hour short stay beds”.

A 24 hour service is not planned for Dublin’s Children’s UCCs.

Staffing the CHI Emergency Department at St. James (due to open 2023) and the two UCCs at Connolly and Tallaght with Paediatric Emergency Medicine consultants present on all shifts would require a complement of approximately 40 consultants and a new consultants contract. Further diagnostic support services hours throughout opening hours would also be required at all 3 sites.

Operating the current proposed model must, if nothing else, be urgently and accurately costed.