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
- Clinical Psychologist,
- Occupational Therapist/Physiotherapist
- Speech and Language Therapist
- Play Specialist
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