Service Reconfiguration

04.07.12

Decision day for children’s heart surgery

The children’s heart surgery units that are to close to improve clinical care will be revealed today, centralising surgery at six or seven hospitals instead of 11.

The Joint Committee of Primary Care Trusts (JCPCT) announcement is being nervously anticipated in some cities, such as Leeds and Southampton, where campaign groups have been opposing the plans.

The national review into streamlining paediatric congenital cardiac surgery services followed the inquiry into poor care at Bristol Royal Infirmary in the early 1990s.

Although fewer hospitals will conduct heart surgery, children who need care will still be able to access services nearer their homes for ongoing care.

This has failed to placate parents, with the petition to keep open theLeedsunit alone attracting 600,000 signatures.

Steve Bolsin, the consultant anaesthetist at the Bristol Royal Infirmary who exposed the deficiencies in children’s heart surgery there, told the Guardian that the delay in reorganising children’s heart surgery into fewer units has been appalling and “just unthinkable”, adding: “I'm sure there were more deaths.”

The JCPCT will pick one of the following options on which units to keep open:

-          Leeds, Liverpool,Bristol,Birminghamplus two inLondon

-         Newcastle, Liverpool, Leicester,Birmingham,Bristolplus two inLondon

-         Newcastle, Liverpool,Birmingham,Bristol, Southampton plus two inLondon

-         Newcastle, Liverpool,Birmingham,Bristolplus two inLondon

The Royal Brompton Hospital in London is likely to close, with the consultation saying keeping open the Evelina Hospital and Great Ormond Street was the ‘preferred option’ – although this has been strongly challenged by the Royal Brompton, which won a High Court ruling declaring the consultation flawed. But the Court of Appeal overturned that ruling in April.

Professor Deirdre Kelly has been appointed Chair of the Safe and Sustainable Implementation Advisory Group, which will provide advice to commissioners on implementing the changes following today’s announcements.

It will advise on the creation of Congenital Heart Networks and the development of referral pathways; the development of quality standards for Children’s Cardiology Centres and District Children’s Cardiology Services; the implementation of the Safe and Sustainable standards for Specialist Surgical Centres; how to improve systems for the collection, analysis and reporting of outcome data; the training and workforce implications of the JCPCT’s decision; and the impact on other paediatric services, such as paediatric intensive care and paediatric retrieval services.

Professor Kelly, medical director of Birmingham Children’s Hospital from 2000–07 and now Professor of Paediatric Hepatology at the Paediatric Liver Unit at the hospital said the changes “will ensure that children and families receive co-ordinated high quality care which is safe and effective, based on their specific needs”.

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