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RMCH has offered world-class care for children with intestinal failure for 30 years. However, for the past year, work has been going to formalise the service which is now nationally and internationally recognised. The new unit is named Children & Adolescent Intestinal Rehabilitation & Reconstruction Services (CAIRRS), where all new and old patients are admitted for assessment and treatment.

Intestinal Failure (IF) is defined as the need for total intravenous feeding for more than four weeks in normal baby or infant or child who is unable to be fed orally for whatever reasons, irrespective of whether the child has a normal bowel.

A working group led by Consultant Paediatric and Neonatal Surgeon Antonino Morabito, Consultant Paediatric Gastroenterologist Andrew Fagbemi and Ward Manager Julie Jolly was established to introduce a multi-disciplinary approach, ensuring that the patient pathway is a smooth and coherent process.

Dr Fagbemi said: "Children are now benefitting from multi-disciplinary team working in the new unit. At the moment we are treating about 30 patients a year of which 95% will remain under CAIRRS for period of years. We are envisaging that this figure will increase in the future."

Now when patients are referred either from RMCH, St Mary's Hospital or externally, their case will be reviewed by a Gastroenterologist and/or referring surgeon, before being assessed by the Multi-Disciplinary Team (MDT) within two weeks of admission. The team includes:

  • Specialist Nurses/other nurses
  • Consultant Paediatric Gastroenterologist
  • Consultant Paediatric Surgeon including one with special interest in bowel reconstruction
  • Dietitian
  • Pharmacist
  • Clinical Psychologist,
  • Occupational Therapist/Physiotherapist
  • Speech and Language Therapist
  • Play Specialist
  • Radiologist

The case will then be discussed at one of the weekly MDT meetings where a treatment plan is put in place. The work has reaped rewards and CAIRRS has a reputation that reaches from Manchester to beyond, with patients being sent from overseas.

Dr Fagbemi added: "This working arrangement will give us the best chance of giving our patients the best care possible earlier on in their illness in order to avoid possible short and long term problems."