To ask the Minister of Health to detail any action he is taking to address the paediatric waiting list for percutaneous endoscopic gastrostomy surgery.

There are a number of actions ongoing between my officials and Belfast Health and Social Services Trust (BHSCT) staff to reduce the current waiting times for percutaneous endoscopic gastrostomy (PEG) surgery and to find a sustainable solution to this complex issue. Actions include:

Belfast Trust have commenced additional clinics and theatre sessions to help reduce paediatric waiting times and additional Paediatric Gastrostomy procedures have been approved through waiting list initiative funding. The Trust have carried out a number of additional weekend theatre sessions to help address the backlog and it is hoped that additional sessions will be available going forward dependent on theatre, bed and staffing capacity.

Following a clinical validation exercise it is estimated that around 25 children would be suitable to transfer to an NHS Provider in Great Britain (GB) to receive their surgery. Discussions are ongoing with a number of NHS paediatric providers. Capacity is being sought for the child’s complete pathway including a pre-assessment clinic for these complex children, theatre capacity, inpatient bed capacity (children stay between 48-72 hours), parental training to manage the peg tube, equipment and food, and a follow up appointment. This is required to ensure continuity of care for the children and their parents.

A small number of procedures were also carried out in the Ulster Hospital by Belfast Trust paediatric surgeons. This pathway is being reviewed to determine if this would offer a sustainable solution or provide a short-term solution to reduce lists. Discussions between the two units are ongoing.

The Republic of Ireland (ROI) have confirmed that they do not have capacity at this time to carry out PEG Tube Surgery for children from NI due to their own pressures.

Belfast Trust have also entered into consultation with Independent Sector (IS) Providers in Northern Ireland to explore if there is a provider in a position to safely deliver the necessary arrangements for the child’s complete pathway including a pre-assessment clinic, theatre capacity, inpatient bed capacity (children stay between 48-72 hours), parental training to manage the peg tube, equipment and food, and a follow up appointment. The IS Providers have indicated that they are not in a position to provide this service, at this time.

Whilst RBHSC has been facing increased winter pressures as a result of the enhanced winter planning they have been able to maintain their elective lists, which would include the PEG tube insertions. In previous years elective sessions were cancelled during winter pressure periods.

There is significant work underway between the Belfast Trust paediatric surgeons, the Child Health Partnership and District General Hospital (DGH) surgical units to consider what surgery needs to be carried out in RBHSC and what can be carried out locally at DGHs. A number of elective theatre lists have already been moved to District General Hospitals, and this work in ongoing. This means that theatre and bed capacity in RBHSC is freed to manage children that can only have their surgery in RBHSC. I hope to see some more tangible improvements in the situation as we move into 2025. This will have a knock-on effect on the issue of those children who require the PEG insertion elective procedure.

I want to assure you that officials in the Department as well as colleagues in BHSCT are continuing to work hard to try and address this issue but, given the ongoing pressures on the service and demand for theatre capacity, this will mean that this will not be solved immediately. We will continue to assess and gauge progress on this to ensure that all of the children and young people receive the care they require as quickly as possible.