The Health and Social Care Board (HSCB), Public Health Agency (PHA) and Belfast Trust have today (13 November 2018) set out plans to manage the perinatal and paediatric pathology service in Northern Ireland.
This service is currently provided on a regional basis by the Belfast Health and Social Care Trust and the work is undertaken by a consultant paediatric pathologist. However, this is set to change with effect from early 2019 when the paediatric pathologist will leave this post.
Regrettably, this will have implications for this specialised and important service in Northern Ireland. Despite significant efforts to address this position including repeated recruitment drives both nationally and internationally, it has now been necessary to make alternative arrangements by securing paediatric pathology services from Alder Hey Children’s NHS Foundation Trust in Liverpool. This is very much an interim arrangement and the HSC system will continue to work hard exploring all avenues to provide a local service in the longer term.
Heather Reid, Public Health Specialist, speaking on behalf of the Health and Social Care Board and Public Health Agency said: “We recognise that the loss of a child is one of the most devastating events that can ever happen to a family and fully accept that the prospect of the post-mortem being performed outside Northern Ireland may compound the distress experienced by families.
“While we will have to adapt our service, we want to assure parents that they will continue to have the choice of whether or not to go ahead with a hospital post-mortem. We also believe there are opportunities to provide post-mortem findings more quickly and enhance the support and information families receive.
“While it is acknowledged that a service outside of Northern Ireland is not what we would wish for, working closely with a much larger centre such as Alder Hey will provide a more robust service in the interim period.”
Ms Reid continued: “We are working closely with families, staff, charities and other partners to take every possible step to ensure that any baby or child who requires a post-mortem is treated with the utmost respect, dignity and sensitivity throughout their journey now and in the future and that families will have our full support when facing these very traumatic circumstances.
“In the meantime, the wider Health and Social Care system will continue to exhaust all efforts to try to ensure that a local service can be provided in Northern Ireland in the longer term.”
It is expected that new arrangements will be implemented from January 2019.
This statement relates to hospital perinatal and paediatric post-mortems only.
This service includes hospital post-mortem examinations, the great majority of which are carried out on babies who are stillborn, as well as late miscarriages and babies who survive only a short time after birth. It also includes, much more rarely, hospital post-mortem examinations of older babies and children.
This service is valued and is very important in providing answers to families as to why a baby or child may have died, some of which may have implications for future family planning. Parents will always be given the choice on whether or not they wish to proceed with a hospital paediatric post-mortem examination.
Paediatric pathology is a very small specialist area. In 2016, the Royal College of Pathologists in a survey of the workforce identified 70 consultant posts across the UK, 15 of which are currently vacant, so the challenges are not unique to Northern Ireland.
It is anticipated that working in partnership with Alder Hey will enhance some of the services currently undertaken including:
Post-mortems ordered by the Coroner, where the circumstances of the death falls under Section 7 of The Coroners Act (Northern Ireland) 1959 are undertaken locally. This service is provided outside of the HSC through a separate contract with the Department of Justice.