Children's Acute Transport Service

The Children's Acute Transport Service (CATS) is a publicly funded paediatric intensive-care transport and retrieval service based in England. It was established in 2001 as a collaboration among the regional paediatric intensive care units at Great Ormond Street Hospital for Children, St Mary's Hospital in London, and the Royal Brompton Hospital. CATS was created to address a structural problem in paediatric emergency care: only a minority of hospitals have a paediatric intensive care unit, so critically ill children often first arrive at district general hospitals that cannot provide the full range of intensive-care treatment they require. The service supports hospitals across the North Thames and East Anglia regions, covering approximately 50 district general hospitals. Its teams provide specialist clinical stabilisation, retrieval, and transfer to an appropriate regional paediatric intensive care unit. CATS receives roughly 2,200 referral calls and undertakes about 1,200 critical-care retrievals each year according to the referenced service description. More than three quarters of the transported children require anaesthesia and mechanical ventilation, around one third require inotropic cardiovascular support, and a small proportion require inhaled nitric oxide during transfer. The service also provides telephone advice, coordination with specialist clinicians, and education and outreach for referring hospitals. CATS operates through a multidisciplinary model involving intensive-care consultants, specialist nurses, rotating nurses from the region's three paediatric intensive care units, administrators, ambulance personnel, and aviation partners. Consultants oversee clinical delivery, supervise junior doctors, contribute to outreach teaching, and participate in service development while maintaining their intensive-care and anaesthesia skills in their base units. A dedicated nursing team supports retrieval operations, training, and the outreach programme. Administrators provide continuous coverage for the referral hotline and coordinate communications, teleconferences, and team mobilisation. Ground transfers are carried out by St John Ambulance using bespoke intensive-care ambulances designed for CATS operations. Between approximately five and ten percent of retrievals are conducted by air, using helicopters and fixed-wing aircraft. For some urgent long-distance missions, CATS works with HM Coastguard helicopter aircraft and crews. The service also participates in specialist national retrieval arrangements, including extracorporeal membrane oxygenation retrievals under service-level agreements with Great Ormond Street Hospital and the Freeman Hospital in Newcastle. In partnership with Great Ormond Street Hospital, it also retrieves children with Vein of Galen malformations who require radiological ablation. CATS has additionally undertaken international paediatric transfers. The service has received accreditation from the Commission on Accreditation of Medical Transport Systems for fixed-wing, rotary-wing, and ground inter-facility critical-care transport. It was also a national winner of a United Kingdom Department of Health Health and Social Care Award in 2005. CATS became more widely known outside the clinical sector through the BBC One documentary series Children's Emergency, an eight-part programme broadcast in 2010. Its identity is primarily institutional rather than commercial: it is an NHS specialist service whose role is to deliver safe, rapid, clinically governed transport and to strengthen the ability of referring hospitals to stabilise critically ill children before retrieval.

The Children's Acute Transport Service was founded in 2001 to provide a coordinated paediatric intensive-care retrieval capability for the North Thames region. Its creation reflected the organisation of specialist paediatric critical care in the United Kingdom, where intensive-care beds and specialist teams are concentrated in regional centres rather than being available at every district general hospital. Children with life-threatening illness or injury may therefore need stabilisation at a local hospital followed by rapid transfer to a paediatric intensive care unit. CATS began as a collaboration involving the paediatric intensive care units at Great Ormond Street Hospital for Children, St Mary's Hospital in London, and the Royal Brompton Hospital. The service subsequently developed as a regional retrieval organisation serving approximately 50 district general hospitals in North Thames and East Anglia. Its remit includes more than the physical movement of patients. Referral staff receive urgent telephone advice, the CATS team liaises with specialist clinicians, and outreach education helps referring hospitals improve the initial stabilisation of children before the retrieval team arrives. The operational model combines dedicated personnel with staff rotating from participating intensive-care units. NHS intensive-care consultants are responsible for clinical supervision, service delivery, education, and development. Full-time CATS nurses support retrievals and coordinate training, while more than 50 nurses from the three participating paediatric intensive care units contribute to the rota. Administrators maintain around-the-clock referral-line coverage and organise clinical communications and team mobilisation. St John Ambulance provides road retrievals using intensive-care ambulances developed for CATS requirements. The service manages a substantial and clinically complex workload. The referenced description records approximately 2,200 referral calls and 1,200 critical-care retrievals annually. More than 75 percent of transported children are sufficiently unwell to require anaesthesia and mechanical ventilation. Approximately one third need inotropic support, and about five percent receive inhaled nitric oxide during transport. These figures illustrate that CATS is not a conventional patient-transfer service but a mobile extension of paediatric intensive care. CATS also developed capabilities for transport by air. About five to ten percent of retrievals use helicopters or fixed-wing aircraft, particularly when distance or urgency makes a road journey unsuitable. Some long-range missions are undertaken with HM Coastguard helicopter crews. The service has carried out international referrals and participates in specialised national arrangements. Service-level agreements cover ECMO retrievals involving Great Ormond Street Hospital and the Freeman Hospital in Newcastle. CATS also works with Great Ormond Street Hospital on retrievals of children with Vein of Galen malformations requiring radiological ablation. Quality and safety have been reinforced through external recognition. CATS received accreditation from the Commission on Accreditation of Medical Transport Systems, covering its fixed-wing, rotary-wing, and ground inter-facility critical-care operations. It was also named a national winner of a Department of Health Health and Social Care Award in 2005. Academic publications associated with the service have examined the stabilisation of critically ill children before retrieval, performance measurement for inter-hospital transport, and the use of inhaled nitric oxide in neonatal and paediatric transport. CATS became the subject of Children's Emergency, an eight-part BBC One documentary series broadcast from May to June 2010. The programme documented the pressures and clinical decisions involved in paediatric retrieval work and gave the service a public profile beyond the NHS and specialist transport fields. Institutionally, CATS is part of the Great Ormond Street Hospital for Children NHS Foundation Trust. Its continuing function is to provide regional and specialist transport, clinical advice, and education for critically ill children requiring access to paediatric intensive care.

• 2010

  Children's Emergency airs on BBC One

  [1]Children's Acute Transport Serviceen.wikipedia.org

  An eight-part documentary series about the service is broadcast on BBC One between 4 May and 23 June.

• 2005

  National Health and Social Care Award

  [1]Children's Acute Transport Serviceen.wikipedia.org

  CATS is reported as a national winner of a Department of Health Health and Social Care Award.

• 2001

  CATS is established

  [1]Children's Acute Transport Serviceen.wikipedia.org

  The Children's Acute Transport Service is created as a collaboration among the paediatric intensive care units at Great Ormond Street Hospital, St Mary's Hospital, and the Royal Brompton Hospital.

A specialist NHS critical-care transport provider focused on rapid, clinically governed retrieval of critically ill children who require transfer from hospitals without paediatric intensive-care facilities.

• Clinical transport service · 2001

  Regional paediatric intensive-care retrieval

  CATS mobilises specialist clinical teams to district general hospitals, helps stabilise critically ill children, and transfers them to an appropriate regional paediatric intensive care unit. Retrievals commonly involve anaesthesia, mechanical ventilation, cardiovascular support, and other intensive-care interventions during transport.

• Ambulance transport · 2001

  Ground critical-care transport

  Road retrievals are provided by St John Ambulance using bespoke intensive-care ambulances designed around the equipment and staffing needs of CATS paediatric missions. The service supports inter-facility transfers across its regional network.

• Helicopter and fixed-wing transport

  Air medical transport

  For selected urgent or long-distance cases, CATS uses helicopter and fixed-wing aircraft. Air missions account for approximately five to ten percent of retrievals in the referenced description and may involve cooperation with HM Coastguard helicopter crews.

• Specialist clinical transport

  Specialist retrieval coordination

  Through service-level agreements and hospital partnerships, CATS supports specialist missions including ECMO retrievals and transfers of children with Vein of Galen malformations requiring radiological ablation. It has also undertaken international paediatric referrals.

• Clinical support and training · 2001

  Referral advice and outreach education

  The service operates a 24-hour referral hotline, provides telephone advice and specialist liaison, and delivers outreach education to improve the stabilisation and preparation of critically ill children before a retrieval team arrives.

• 2010Children's Emergency

  United Kingdom

  The BBC One documentary series followed CATS staff and paediatric retrieval cases across eight episodes, presenting the operational and clinical demands of transporting critically ill children.

  Outcome. The programme increased public visibility of CATS, although no commercial campaign metrics are reported.

  Source

• 2010

  Children's Emergency brings CATS to BBC One[1]Children's Acute Transport Serviceen.wikipedia.org

  Campaign

  BBC One broadcast an eight-part documentary series following the work of the Children's Acute Transport Service and its clinical teams.

• 2005

  CATS receives national Health and Social Care Award[1]Children's Acute Transport Serviceen.wikipedia.org

  Other

  The service was reported as a national winner of a United Kingdom Department of Health Health and Social Care Award.

1. 1Children's Acute Transport Serviceen.wikipedia.org
2. 2Children's Acute Transport Service official websitecats.nhs.uk