Paediatrics Session
AB030. SOH26AB_0130. Expanding paediatric surgery in Ireland: early outcomes following establishment of the University Hospital Limerick (UHL) Regional Service [2023–2025]
Efthymios Koutroumanos1, Rebecca Conway2, Wael Fadel1, Mansoor Ahmed1, Charles Lee1, Eibhlin Burns-Beatty3, Hasnain Aslam3, Wame Majeremane3, Muhammad Salman Qamar1, Nicola Brindley1, Tara Connelly3,4, Brice Antao1
1Department of Paediatric Surgery, Children’s Health Ireland (CHI) at Crumlin, Dublin, Ireland;
2Faculty of Education and Health Services, School of Medicine, University of Limerick, Limerick, Ireland;
3Department of General Surgery, University Hospital Limerick, Limerick, Ireland;
4Health Research Institute (HRI), University of Limerick, Limerick, Ireland
Background: Paediatric surgical services in Ireland have historically been centralised within Children’s Health Ireland (CHI) hospitals in Dublin, leading to long travel distances for families and prolonged waiting times for elective assessment. To improve regional access, the University Hospital Limerick (UHL) Group established a dedicated paediatric special interest surgery service in October 2023. This study aimed to evaluate its early impact on referral patterns, outpatient access, and operative activity.
Methods: A population-based observational study was conducted using administrative and clinical activity data from CHI at Crumlin, CHI at Temple Street, and the UHL Group. Outcomes included: number of referrals from the UHL catchment area to CHI, triage-to-outpatient department (OPD) waiting times, outpatient activity, and operative volume. Data were compared across the pre-implementation of the UHL service period (October 2021–October 2023) and post-implementation period (October 2023–October 2025).
Results: Referrals from the UHL catchment area to CHI at Crumlin and CHI at Temple Street decreased from 279 pre-implementation to 59 post-implementation, an overall 78.9% reduction. During the first 2 years of the UHL service, 742 paediatric surgical outpatient appointments were delivered, including 458 index consultations. The mean UHL triage-to-OPD interval was 94 days. In comparison, CHI triage-to-OPD waiting times averaged 170.21 days across the study period. More than 190 paediatric surgical operations were performed locally in UHL, reflecting the rapid establishment of regional operative capacity.
Conclusions: The introduction of a regional paediatric surgery service within the UHL Group is associated with a major reduction in referrals to CHI in Dublin, significantly shorter waiting times for first OPD review, and increased regional delivery of paediatric surgical care. Early findings support decentralisation as an effective model for improving access, equity, and capacity in paediatric surgery in Ireland.
Keywords: Decentralized care; paediatric surgery; population study; referral pattern; outpatient access
Acknowledgments
None.
Funding: None.
Conflicts of Interest: The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/map-26-ab030
Cite this abstract as: Koutroumanos E, Conway R, Fadel W, Ahmed M, Lee C, Burns-Beatty E, Aslam H, Majeremane W, Qamar MS, Brindley N, Connelly T, Antao B. AB030. SOH26AB_0130. Expanding paediatric surgery in Ireland: early outcomes following establishment of the University Hospital Limerick (UHL) Regional Service [2023–2025]. Mesentery Peritoneum 2026;10:AB030.
