Located at its historic London site, Great Ormond Street Hospital (GOSH) is an international centre for excellence in child healthcare. It receives over 200,000 outpatient visits and 40,000 inpatient visits every year, with most of the children referred from other hospitals in the UK and overseas. The hospital has over 60 different clinical specialties and the UK’s widest range of specialist health services. Its commitment to research and innovation includes a partnership with UCL Great Ormond Street Institute of Child Health and over 500 active research projects underway at any one time.
The hospital is funded partly by The Great Ormond Street Hospital Charity as well as NHS England. It doesn’t have an A&E or urgent care facility so the challenges it faces can be unique in comparison to other trusts.
However, some of the challenges are ones faced by many trusts. Trust chief executive Matthew Shaw highlighted the workforce shortages in paediatric and adolescent nursing which were not addressed in the long-term workforce plan. Patient flow can be a huge challenge, with children and young people (CYP) at GOSH for up to two years, who could have been discharged after only a few months if appropriate social care and support at home was in place.
During the visit the GOSH team talked through their concerns about the lack of focus on CYP health at a national and system level. CYP often don’t get flagged as a population health concern and were clear on the need for a national CYP strategy to address this. National policy is often retrofitted to children’s services, such as the post-Covid-19 recovery approach, which resulted in longer waiting times for children’s services or a slower recovery. They highlighted virtual wards as having potential to shift the dial for children’s services but noted only four out of 12 standalone children’s hospitals have integrated care board (ICB) funding towards virtual wards.
Despite these challenges, the trust clearly has a goal to improve patient experience and outcomes for all, with innovation and research at the heart of everything it does. I was shown a short demonstration of Tortus, an AI software GOSH is currently developing. With a focus on responsible AI usage with human clinical supervision, the software’s transcription function was impressively accurate and the potential for scaling up and reducing admin time for clinicians was massively encouraging.
The trust is currently undergoing a huge development project, due to shortly begin work on a new children’s cancer centre that will see the front of the main hospital demolished and a larger cancer wing built in its place. I saw a virtual walk-through of the new space, which includes a 100-metre roof garden, a four-level cancer wing and new inpatient facilities, theatre suite and imaging services. Crucially, all bedrooms have space for a parent to stay and with room to play, eat and work, encouraging a normal family routine.
The new construction includes a new hospital school. The school’s headteacher Jayne Franklin spoke passionately to me about the education rights of children at GOSH. She pointed out that the school represents a vital continuation of their education but is often the only familiar setting in their lives during that time. The new hospital school design reflects feedback from children; it includes a sensory room, an immersive technology room and a terrace with natural light, offering accessible outdoor learning.
I left GOSH reflecting on the importance of ensuring children’s services do not fall off the agenda, deeply inspired by the incredible services the trust offers its young patients. The commitment to teaching, research and innovation is palpable in all the GOSH team does as they strive for continuous improvement and positive impact on the communities they serve and beyond.
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