Caring for children in isolated small hospitals--problems and solutions?

摘要

A high priority for most parents is to have ready access to paediatric medical services, particularly when their child becomes ill. A difficult balance is therefore sometimes required between the provision of these services in a small local hospital where the throughput of work (and hence opportunities for education and training) will be limited, and the disadvantages of distance and delay where there is geographical isolation from such services. It is also important that doctors have the opportunity to gain experience in the range of environments in which they may work after completion of their training, whether in primary or secondary care. We report an innovative initiative to sustain a local inpatient paediatric service and to enhance the provision of education and training for doctors through development of a training network and rotation. We also highlight issues arising from this, in particular the implications for adequate availability of support from career grade paediatric staff.