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Anger as NHS England plans to close child heart disease units

Three child heart disease units are due to be transferred to other hospitals after NHS England found that they failed to meet new commissioning standards.

NHS England announced today that it plans to transfer congenital heart disease surgical and interventional cardiology services from University Hospitals of Leicester NHS Trust, Royal Brompton & Harefield NHS FT and Central Manchester University Hospitals NHS FT to neighbouring hospitals.

It said the proposals were subject to consultation from the trusts and, if relevant, members of the public. But it added that the trusts were not meeting new commissioning standards for congenital heart disease that were introduced last year and it was “highly unlikely” that they would be able to do so.

Jonathan Adler, chief executive at University Hospitals of Leicester NHS Trust, responded angrily to the proposals, saying: “We strongly disagree with NHS England’s decision and will not sit by whilst they destroy our fabulous service.”

He added that the trust had implemented measures to meet the NHS England standards in the past 18 months, including increased beds, investment in staffing, plans to create a new single site children’s hospital and improved clinical outcomes which were “amongst the best in the country”.

Royal Brompton calls proposals ‘absurd’

Likewise, Robert Craig, chief operating officer at Royal Brompton & Harefield NHS FT, said: “While we understand the motivation of commissioners to show progress is being made with congenital heart disease services, threatening to withdraw services from one of the largest and most successful centres in the country seems an absurd approach.”

He added that Royal Brompton Hospital carries out over 500 congenital heart disease operations a year and proposals to transfer the procedure to other hospitals were “ill-conceived”.

Craig criticised NHS England for a lack of engagement with the trust and said that if the proposals went ahead, it would also have an adverse effect on Royal Brompton & Harefield’s services in paediatric intensive care, specialist respiratory services and pulmonary hypertension.

He welcomed the review of the proposals, saying: “We fail to see how any logical review of the facts will come to the same conclusion as this panel.”

In addition, NHS England said it will transfer congenital heart disease services from Central Manchester University Hospitals NHS FT to Alder Hey Children’s Hospital NHS FT and Liverpool Heart and Chest Hospital NHS FT.

In a statement, Central Manchester University Hospitals NHS FT said that although it was “disappointed” by the decision, the care of patients was “paramount”.

It added: “To that end we are seeking urgent clarification from NHS England on the practical details of the transfer process and timescales, so that we can reassure our patients and staff and try to address their concerns. Our priority will be to work closely with colleagues in both NHS England and Liverpool to make the transition as safe and smooth as possible for our patients and their families.”

Other hospitals also under review

In addition, NHS England raised concerns about other hospitals, saying it would:

• Work with Newcastle Hospitals NHS FT to ensure progress is made towards meeting the standards so that the hospital’s paediatric heart transplant centre is sustainable and resilient.

• Support and monitor progress at University Hospitals Bristol NHS FT, Leeds Teaching Hospitals NHS Trust, University Hospitals Birmingham NHS FT, Barts Health NHS Trust, Guy’s and St Thomas’ NHS FT, and University Hospital Southampton NHS FT to assist them in meeting the standards.

• Continue to commission Birmingham Children’s Hospital NHS FT and Great Ormond Street Hospital for Children NHS FT, which meet the standards, with ongoing monitoring.
• Work with Blackpool Teaching Hospitals NHS FT, University Hospital of South Manchester NHS FT, Papworth Hospital NHS FT, Nottingham University Hospitals NHS Trust and Imperial College Healthcare NHS Trust to cease occasional and isolated specialist medical practices and transfer services to other appropriate providers.
• Support and monitor progress at Liverpool Heart and Chest hospital to develop services in line with standards.
• Monitor Norfolk & Norwich University Hospitals NHS FT and Brighton and Sussex University Hospitals NHS Trust’s progress towards meeting the standards.

It also said a small number of hospital trusts not recognised as specialist centres, which occasionally undertook interventions, had been instructed to make arrangements for congenital heart disease patients to be cared for at a specialist centre in the future.

NHS England has also promised to improve its care for child patients with heart problems after a review found shortcomings at Bristol Royal Hospital for Children.

Dr Jonathan Fielden, NHS England director of specialised commissioning and deputy national medical director, said: “Patients, families and staff need to be assured of sustainable, high quality services now, and into the future.

“There has been a great deal of uncertainty over the future of congenital heart disease services over the past fifteen years. We owe it to patients, families and staff to end that uncertainty, and to provide clear direction for the safety and quality of this specialist area of medicine going forward.

“A great deal of work has gone into achieving consensus across the board on the standards that providers should meet. We are determined to take all actions necessary to ensure that those standards are met, so that patients get the high quality and safe services that they expect and deserve.

“This is further proof that NHS England as the national commissioner of specialised care is stepping up decisively on behalf of patients now and to sustain quality care for the future.”

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