My hospital has a large, rural catchment area. Should we be imposing maximum travel times or distances when agreeing to day-case surgery for children? Should we consider this for certain age-groups, perhaps under-1s or under-5s?
There are no national guidelines on this issue; even the AAGBI adult guidelines are not specific on maximum travel distances (Verma R, Alladi R, Jackson I, et al. Day case and short stay surgery: 2, Anaesthesia 2011; 66: pages 417-434).
From the panel and delegate discussions, it was clear that this is an issue that raises questions frequently with hospitals around our region, especially as the time it takes to travel from areas of the Pennines, Northumberland and Cumbria to any hospital could be large.
There was a feeling from the audience that a pragmatic suggestion of a one-hour travel time would be sensible when considering day-case surgery, but this needs to be tempered with consideration of other factors including the age and comorbidities of the child, the type of surgery, and the likelihood of significant complication. However, more than one experienced clinician pointed out that they had never had a problem with allowing children to travel home further than this.
