External clinical review – 1st December 2022

In order to ensure we maintain good standards and safety and clinical outcomes in our service, and to continuously improve the clinical outcomes of our service, Children’s Health Ireland has commissioned an external clinical review of the complex spinal surgeries carried out in Temple Street on children with spina bifida over the past 3 years.

The external clinical review will involve expert clinicians in spinal surgery from international North American centre of Excellence. They will examine Children Health Ireland at Temple Street practices, procedures and patient outcomes in relation to complex spinal surgery in patients with spina bifida with a view to advising whether there are clinical outcomes and patient safety-related issues and recommendations to continuously improve our service.

Spina bifida is a complex condition which affects multiple systems in the body. Children born with spina bifida have extremely complex needs and those needing spinal surgery are the most complex. As can be seen internationally, these complex cases do unfortunately have a high rate of complications. This year, in order to improve access and address long waiting times for patients, Children’s Health Ireland increased the number of complex surgeries undertaken for children with spina bifida.

For comparison, less than five complex patients were operated on in CHI at Temple Street in 2021, compared with 11 complex patients to date in 2022. As we increased the number of surgeries undertaken over the summer, an increase in complications was noted by several clinical teams.

While this external clinical review is underway, CHI has made a decision to pause complex spinal surgery on those children with spina bifida who are having kyphectomy surgery as this is the most complex type of spinal surgery in this group of children.

It is estimated this clinical review will take approximately four months. This clinical review concentrates on Children’s Health Ireland at Temple Street at this time. The Improvements and recommendations will however be shared across all of Children’s Health Ireland.

There are less than five children currently waiting on this specific surgery and they will be offered a Multi-Disciplinary Team review to assess their needs (as is international best practice) and see if there are any new care needs or actions we can take to support them at this time. Parents and guardians of children affected have been informed and this direct patient contact will remain the priority of Children’s Health Ireland and our staff.