To ask the Minister of Health, pursuant to AQW 14759/22-27, for an update on the progress of the waiting list initiative for percutaneous endoscopic gastrostomy surgery.

On the 24th October there were 74 children currently on the waiting list for this elective procedure. However, this number changes regularly with some children getting the procedure carried out whilst other children are added to the waiting list for the procedure.

As stated previously my officials have been working with Belfast Health and Social Care Trust (BHSCT) to identify measures in order to try and address this ongoing issue.

The Belfast Trust has commenced additional clinics and theatre sessions to help reduce paediatric waiting times and additional paediatric gastrostomy procedures have been approved through waiting list initiative funding. The Trust has now scheduled additional weekend theatre sessions dates between October and December to help address the backlog.

A paediatric surgeon has now completed a validation of Peg Tube waiting lists to identify which children would be clinically suitable to transfer to Alder Hey Hospital in Liverpool for the procedure. The clinical criteria for transfer has been agreed by the specialist team to determine this. BHSCT is currently in negotiations with Alder Hey Hospital to identify what capacity they may have to offer. However, like RBHSC, they are currently also experiencing unscheduled seasonal pressures. The capacity required will be pre-assessment of these complex children, theatre capacity, inpatient bed capacity (children stay between 48-72 hours), parental training to manage the peg tube, equipment and food, and a follow up appointment.

Further discussions are also underway with South Eastern Trust to provide the Belfast Trust paediatric surgeon with a surgical list in the Ulster Hospital. Belfast Trust Gastrostomy Specialist Nurses will provide training to staff in South Eastern Trust to help facilitate this. A number of children have been identified to be managed on the South Eastern Trust theatre list.

A further review of surgical work performed in RBHSC is underway and any work that can be redirected to District General Hospitals will be transferred. This may free up capacity in RBHSC for Paediatric Surgeons to perform more gastrostomy surgery and other more complex surgery that can only be carried out in RBHSC.

The Trust are also examining partnership working with the Private Sector however there are a number of areas that the Trust would need to have assurance on for the delivery of safe and effective care of these complex children many of which have other multiple co-morbidities.

My officials will continue to meet with BHSCT to discuss these potential solutions and examine their progress and success.

I want to assure you that officials in the Department as well as colleagues in BHSCT are continuing to work hard to try and address this issue but, given the ongoing pressures on the service and demand for theatre capacity, this will mean that this will not be solved immediately. We will continue to assess and gauge progress on this to ensure that all of the children and young people receive the care they require as quickly as possible.