National variations within the timings of transport to paediatric intensive care from 2018 to 2022: a cohort study

OBJECTIVE: This study aims to describe the differences in Paediatric Critical Care Transport (PCCT) timings across the UK and Ireland to help explore challenges in access faced by different regional teams. DESIGN: Retrospective cohort study. SETTING: Emergency transports to paediatric intensive care units (PICUs) across the UK and Ireland where data were captured by the Paediatric Intensive Care Audit Network. POPULATION: Children under 16 years of age requiring emergency PICU transport between 1 January 2018 and 31 December 2022. MAIN OUTCOME MEASURES: Incidence of PICU transport and the variations in the time taken for the transport teams to mobilise and reach the bedside. RESULTS: Over the 5-year period, there were 20 167 transports of 17 834 children. Over 40% (n=8561) of transports were undertaken by two PCCTs based in London and Southeast England. The greatest risk of mortality (Paediatric Index of Mortality (PIM3)>5%) was seen across children transported by PCCTs covering England and Wales (median PIM3>5%=26.0%). Only PCCT services in England achieved a median time to mobilise <30 min. Nearly 25% of transports by the three teams covering Scotland, Southwest England, South Wales and Ireland took >3 hours to reach the bedside. CONCLUSIONS: This is the first cohort study comparing timing differences between PCCT services and highlighting the different challenges. Delays in PCCT mobilisation may suggest operational or resource difficulties.