Barriers to accessing paediatric critical care and surgery: A qualitative study

Background: Certain groups of children and young people (CYP) living in the North East and North Cumbria (NENC) present late to paediatric critical care (PCC) and surgery in children (SIC) services, resulting in poorer clinical outcomes. This suggests inequitable access; however, the factors influencing access to these services are presently unclear. Aim: To explore inequitable access to PCC and SIC for CYP and inform recommendations for service improvement. Design: Qualitative study using semi-structured interviews. Setting: Community settings in NENC, United Kingdom. Participants: CYP with experience of PCC/SIC, their caregivers, healthcare professionals, and charity staff. Analysis: Data were analysed using a combined deductive-inductive approach, informed by the UK Paediatric Critical Care Society Quality Standards. Results: Barriers to access were grouped into three categories: communication, system-level, and socio-economic factors. Communication and system-level barriers align with existing quality standards, whereas socio-economic influences are not explicitly addressed but play a significant role in shaping access for some families. Conclusion: Access to PCC and SIC is shaped by interacting communication, system, and socio-economic factors that may delay timely care. Greater recognition of socio-economic influences within service standards and policy may support more equitable access. Further research should focus on improving engagement with CYP and caregivers from underrepresented groups.