An innovative Paediatric Anaesthetic Pre-Assessment Clinic which is being piloted at the Ulster Hospital has transformed surgical services since its launch in January 2025, achieving a remarkable 77 per cent reduction in late surgery cancellations and significantly improving theatre efficiency.
This new clinic is Nurse-led and Consultant-supported, ensuring children are fully prepared for surgery through clinical assessment, health optimisation, anxiety management, informed consent and health screening.
Staff Nurse, Lindy Ketley explained “Since the service began, children and their families are much better educated and prepared for their procedure. Parents receive clear information about what to expect with a general anaesthetic and they can share any concerns their child may have, which we then feed through to our Play Specialist Team.”
The team also carries out a 48-hour pre-surgery check-in with families. Lindy added, “If a child is unwell or taking antibiotics, we identify this early on and working with the admin team, we can reschedule and replace that slot with another patient. This prevents wasted theatre time and gives families reassurance that their child is fit and well for surgery.”
The clinic’s impact has been praised by South Eastern Trust, Consultant Anaesthetist, Dr Ciara Mitchell, who described the nursing staff as the “hidden heroes” of the service.
“Pre assessments and the benefits are really well recognised in other areas, such as Endoscopy. A Paediatric pre-assessment service has really allowed us to translate these benefits into this service. We can see the benefits of this service in improving patient safety and the quality of patient care.”
Dr Mitchell continued, “One of the big benefits that we have seen is a reduction of day of surgery cancellations. Nearly half of those cancellations were due to patients being not fit to proceed on the day.“These patients, if they are unwell, are rescheduled and through that close collaboration with the Nursing and Administration Teams, they then replace these late cancellations with another patient on the list.
“It is great to be able to capitalise on that Nurse level of clinical experience and enthusiasm. They really have a ‘can do’ attitude to make this service work and be effective. There are some ‘hidden heroes’ in this process. The staff have been key in making this work, using their resources differently to make the service a success.”