Optimising postoperative care for elective spinal surgery in paediatrics: a Belfast perspective

Dr Thomas Dowling, paediatric registrar at Belfast Health and Social Care Trust, presents findings from an audit on elective spinal surgery patients in Belfast, focusing on the need for postoperative paediatric intensive care. The study reviewed two years of cases involving 42 patients and found that only three required level two or three interventions—those typically associated with paediatric intensive or high dependency care. Most patients had minimal intervention needs, suggesting that many could be managed safely on the ward rather than in intensive care. Dr Dowling highlights the unique challenge in Northern Ireland, where there is currently no dedicated high dependency unit; as a result, patients who might otherwise be managed in such a setting are admitted to paediatric intensive care. He discusses ongoing efforts to review existing guidelines, adapt care environments, and work with stakeholders to develop and demonstrate the need for a paediatric high dependency unit in the region. This interview took place at the RCPCH conference 2025 in Glasgow, Scotland.