Prioritising paediatric health programme puts children front and centre

Sangeeta Kandola: Babies, children and young people require specialist care regardless of their diagnosis.

Evelina London Children's Hospital is one of only two specialist children's hospitals within the capital. We spoke to their Medical Director, Sara Hanna.

Interviewer: Sara Hanna, thank you for joining me.

We're talking about children's healthcare.

What's it like now? What are the challenges?

Sara: So I think the biggest challenge that's facing child healthcare is the gap in outcomes between the babies and children that come from the most well-off families, and those that are from the most deprived, and particularly from particular ethnic groups.

And that has got definitely worse over the last few years.

And I think what's going to be the real challenge is in the face of incredible advancements in technology, in developing therapies and diagnostic means, on one hand, balancing that with making sure that we're providing equitable care to all our population.

Interviewer: Now you've talked about advancements, nowadays, you can actually restore eyesight. That's incredible.

Sara: Yes, it is.

So you're talking about gene therapy with children with a congenital abnormality in their eyes.

And yes, so we have a small number of children that have had injection of gene therapy into their eyes and it has restored their sight.

We have other children that are receiving gene therapy for muscular conditions, and these advancements are quite incredible.

And I think we will see more and more.

You've probably heard in the news around some of the blood disorders that may well be curable in the future.

So, no, it's very exciting, very exciting.

Interviewer: And you work with academic partners to make sure that you can carry on with these developments?

Sara: Yeah, so I think the key to good outcomes for patients is close work in collaboration.

Also, probably just being part of the same thing, between academic research, education and training and clinical care, there's loads of mutual benefits.

So the academics are more likely to know the questions that are really relevant and prioritised by our patients and clinicians if they're working closely with us.

Similarly, we know in hospital that if we have academic research happening, we're more likely to retain staff and attract staff.

We're more likely to have good outcome for patients.

I mean, it's a fact that hospitals that have clinical research as a high priority have lower mortality rates.

So it's a win-win for everybody.

Interviewer: Now, you've been medical director since 2014. You must have seen some huge changes since then.

Sara: Yeah, huge changes.

I think in terms of how we're able to diagnose earlier and earlier, and more precisely than ever before.

How we're able to treat some rare and devastating conditions.

But I think also just in the attitude and the way we provide healthcare to children.

So in particular, the emphasis on providing it closer to home or in the home is really, really important.

So being able to diagnose, being able to monitor, being able to treat, even the most advanced therapies delivered in the home like dialysis and ventilation for children with respiratory failure.

These technologies have been advancing year on year, and some of those things are now just standard of care.

Interviewer: And you see families going through some of the most difficult situations.

Sara: Yes.

Interviewer: How does that impact you and your staff?

Sara: That's a good question.

I think, so overall in healthcare, it attracts people that are naturally empathetic, and child health, women's health, maternity, that's probably even more so.

So on the spectrum of caring professionals, probably neonatal paediatric nurses, they're pretty far out there.

And so they are incredibly well placed to work with families and children and young people.

But at the same time, they are people that are going to be emotionally affected by the things they see.

So actually one of the things that has advanced in the last few years is the idea of supporting our staff.

Who knew? (both laugh)

And not just in terms of occupational health, but in terms of psychological support.

And actually at Evelina London, we're probably one of the first places to have staff psychology kind of embedded across our whole provisions.

So we have psychologists that look after our maternity service, psychologists in child health, and they really help us because things happen.

So really very distressing things happen.

And the ability to be able to say to staff, "No, we have some people that can help you", is really important.

It keeps people in work actually, otherwise would end up, you know, being off sick with stress for long periods of time.

Interviewer: And some people receive letters, photographs, years later from former patients.

Yeah, so there's lots of things that are gratifying and inspiring, that's absolutely right.

And so most of the time, that's how it is in child health, it's really good things happening.

But just recognising that sometimes things don't go the way we would like them, and we need to be able to have support for our staff in those positions.

Interviewer: Okay. Sara, thank you very much.