Clinicians', policy makers' and patients' views of pediatric cross-border care between Malta and the UK.
OBJECTIVE
The Malta-UK cross-border health care collaboration gives Maltese patients access to highly specialized care that is not available locally. Our aim was to identify the issues that arise in cross-border specialized care for rare childhood diseases.


METHODS
We conducted 31 semi-structured face-to-face interviews with policy makers, consultant pediatricians from Mater Dei Hospital in Malta, the Royal Marsden Hospital and Great Ormond Street Hospital in England and the parents of a random sample of children referred for treatment abroad in 2011. We conducted qualitative thematic analysis of the data.


RESULTS
Respondents viewed the collaboration as successful in providing timely access to high quality specialist care. Four factors facilitated implementation: long established personal relationships; communication and data sharing; shared care approach; and well established support systems. The key challenges are logistical, financial, communication and cultural and psychological.


CONCLUSIONS
Cross-border care pathways can successfully support access to high quality specialized care that is acceptable to health professionals and patients.
Research fellow, European Centre on the Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom vanessa.saliba@lshtm.ac.uk.
Vanessa
V
Saliba
Lecturer, Health Services Management Department, Faculty of Health Sciences, University of Malta, Msida, Malta Faculty of Health, Medicine and Life Sciences, CAPHRI School of Public Health and Primary Care, Department of International Health Maastricht University.
Natasha Azzopardi
NA
Muscat
Higher Specialist Trainee, Department of Paediatrics, Mater Dei Hospital, Msida, Malta.
Mairi
M
Vella
Head Academic Department of Paediatrics, The Medical School, University of Malta, Msida, Malta.
Simon Attard
SA
Montalto
Manager, Treatment Abroad, Ministry of Health, Elderly and Community Care, Valletta, Malta.
Charlene
C
Fenech
Professor of European Public Health, European Centre on the Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Martin
M
McKee
Lecturer, European Centre on the Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Cécile
C
Knai
cross-border care; patient care pathways; pediatric; rare diseases