Final Report > Recommendations > The care of children > Planning the future of children's healthcare services

Planning the future of children's healthcare services

177. There must be much greater integration of primary, community, acute and specialist healthcare for children. The NSF should include strategic guidance to health authorities and trusts so that services in the future are better integrated and organised around the needs of children and their families.
178. Children's acute hospital services should ideally be located in a children's hospital, which should be physically as close as possible to an acute general hospital. This should be the preferred model for the future.
179. In the case of existing free-standing children's hospitals, particular attention must be given to ensuring that, through good management and organisation of care, children have access when needed to (a) facilities which may not routinely be found in a children's hospital and (b) specialists, the appointment of whom in a children's hospital could not be justified given the infrequent call on their services.
180. Consideration should be given to piloting the introduction of a system whereby children's hospitals take over the running of the children's acute and community services throughout a geographical area, building on the example of the Philadelphia Children's Hospital in the USA.
181. Specialist services for children should be organised so as to provide the best available staff and facilities, thus providing the best possible opportunity for good outcomes. Advice should be sought from experts on the appropriate number of patients to be treated to achieve good outcomes. In planning and organising specialist services, the requirements of quality and safety should prevail over considerations of ease of access.
182. Where specialist services for children are concentrated in a small number of trusts spread throughout England, these trusts should establish Family Support Funds to help families to meet the costs arising from travelling and staying away from home. The Funds should be administered flexibly and should not be limited to those on income support or with low incomes.
183. After completion of a pilot exercise, all trusts which provide acute hospital services for children should be subject to a process of validation to ensure that they have appropriate child- and family-centred policies, staff, and facilities to provide a good standard of care for children. Trusts which are not so validated should not, save in emergencies, provide acute hospital services for children.