Children's Acute Transport Service clinical outcomes

Clinical outcomes are broadly agreed, measurable changes in health, function or quality of life that result from our care. Constant review of our clinical outcomes establishes standards against which to continuously improve all aspects of our practice.

The Children's Acute Transport Service (CATS) is a specialised service designed to transport critically ill children quickly and safely between hospitals in the North Thames regions. The CATS team is hosted and located at Great Ormond Street Hospital (GOSH).

Paediatric intensive care is only provided in a small number of hospitals across the North Thames regions. However, children can become critically ill in hospitals where there is no paediatric intensive care unit. Where this is the case, the CATS team travel to the hospital required, start intensive care support for the child and then provide safe and speedy transfer of the child to a hospital with a paediatric intensive care unit.

The CATS team is the largest dedicated children’s intensive care transport team in UK. They stabilise and safely transfer more than 1,100 sick babies and children each year to paediatric intensive care units across London. The main units are at GOSH in Holborn, St Mary’s Hospital in Paddington, Royal Brompton Hospital in Chelsea and Royal London in Whitechapel. Children are sometimes transferred to Evelina Children’s Hospital in Westminster, St George’s Hospital in Tooting, and King’s College in Denmark Hill.

CATS aims to provide the highest quality paediatric intensive care for patients and their families, from the point of referral at the hospital they are in, to the handover of care at the paediatric intensive care unit that they are going to.

The CATS team has developed service standards to ensure it provides the highest quality of care to patients and their families. One of these service standards is the time it takes for a team to be ready to go once the decision to accept a patient has been made. This is known as the mobilisation time.

Timely mobilisation ensures that the CATS team can arrive at the hospital site to start intensive care for the patient and are able to safely transport a child to where is required as quickly as possible. We report below the proportion of patient transports (retrievals) where the team departs the transport base within 30 minutes of accepting a referral. For April 22 to March 2023, the CATS team mobilised within 30 minutes for 84.6% of patient transports, this increased from 59.2% in 2019/2020 where COVID restrictions impacted on service delivery. We closely monitor mobilisation times, however during busy periods (eg winter months) the CATS team may be transporting another patient when a new referral has been accepted. All patients continue to receive the highest quality of care whilst waiting for the CATS team to become available.

This measure is a national measure that is reported to commissioners by paediatric intensive care transport services.

Numerator: Number of emergency transports (excluding planned transfers) where the team departs the transport base within 30 minutes from the time the referral is accepted.

Denominator: Total number of emergency transports (of a patient) undertaken.

At times of peak demand for paediatric intensive care services (mainly in winter months), the CATS team may on occasion be unable to transport a patient within an acceptable time frame. In this event the patient’s condition is assessed. The patient may then be referred to another nearby transport service or continue to be cared for at the local hospital while waiting for the CATS team (or other transport service) to become available. All patients are monitored to ensure they receive the highest quality care.

We report the proportion of refused requests for the emergency transport of a patient, within our defined catchment area and scope.

This measure is a national measure that is reported to commissioners by paediatric intensive care transport services.

Numerator: Number of requests (within defined catchment and scope of retrieval service) for transport of a patient requiring paediatric intensive care admission that are refused.

Denominator: Total number of requests (within defined catchment and scope of the retrieval service), for transport of a patient requiring paediatric intensive care admission.