BACKGROUND TO THE DEPICT STUDY

Around 20 years ago there were changes to how paediatric intensive care services were organised. Before that, children who needed intensive care treatment were cared for in different ways - sometimes they were looked after in a small number of paediatric intensive care units but frequently children were cared for in adult intensive care units or general children wards. It was decided that better care could be offered by centralising these services. This meant that children would now only be looked after in a small number of dedicated paediatric intensive care units, 25-30 in total, with each centre serving a particular region; these paediatric intensive care units offer care to between 8 and 20+ children at any one time.


The benefit of dedicated units is that staff can build up greater expertise by working exclusively in these units, and these units have more money to purchase specialist equipment and other resources. The evidence suggests that this approach means more children have a better outcome. The approach of centralising care has been successfully implemented in other NHS services too, like cancer surgery and treating patients with trauma injuries (major injuries sustained through such things as road traffic accidents).


Offering centralised intensive care services meant that now these very sick children needed to be transferred from their local hospitals to these specialist units, safely and efficiently, and this led to the development of “mobile intensive care” ambulances that pick up children from their local hospitals, start intensive care straight away and then deliver them to the PICUs. Each year, 6000 children require emergency transfer from a local hospital to a PICU, which involves, on average, a journey of about 20-30 miles. There are about 9 of these services around the country and they all operate slightly differently. The DEPICT study aims to describe these differences and to see what variations are important – to both the child being transported and to their families.