Shake-up for child heart op units

July 4, 2012

On 4 July 2012, Nick Triggle, Health correspondent, BBC News, reported: ‘Child heart surgery should be stopped at three of the 10 hospitals that perform the procedures, NHS bosses say. The official review concluded the units at Leicester’s Glenfield Hospital, Leeds General Infirmary and London’s Royal Brompton should stop surgery. The review – set up on behalf of England’s 151 primary care trusts – concluded expertise was spread too thinly across the health service. However, the units will remain open to focus on care before and after surgery. The ruling by the Joint Committee of Primary Care Trusts means patients in England, Wales and some from Northern Ireland will have surgery at one of seven hospitals in the future.

They will be Great Ormond Street in London, Evelina Children’s Hospital, also London, Newcastle’s Freeman Hospital, Birmingham Children’s Hospital, Alder Hey in Liverpool, the Royal Children’s Hospital in Bristol or Southampton General. Sir Neil McKay, chairman of the committee, said it was a “landmark” decision which would improve care. “The needs of children, not the vested interests of hospitals, have been at the heart of this review.”

News of the heart unit closure was greeted with dismay in Leeds. The hospitals affected immediately expressed disappointment at the decision, made after an eight-hour meeting of the committee, set up to represent the 151 primary care trusts across England. The Royal Brompton, which had challenged the consultation process in the courts, has argued stopping surgery would put its children’s intensive care unit at risk.

On hearing the news, Bob Bell, the trust’s chief executive, said: “It is very difficult to know what to say at times like these. “But it is even more difficult to try and understand how this committee could have come to such a decision.” However, the changes were welcomed by doctors’ groups. A joint statement by the Royal College of Surgeons of England and the Society for Cardiothoracic Surgery said: “All surgeons want to be able to deliver the best quality of care for every patient. “While we understand that people do not want to see the unit that is close to them close, the extensive review process indicates that improvements are achievable by concentrating children’s heart surgery in fewer, larger units in England.”

Child heart surgery is one of the most complex undertaken in the NHS. About 3,600 operations are carried out each year on children born with a range of heart defects. Most survive to adulthood, but there is widespread agreement that, to provide a uniformly high quality and safe service, operations must be concentrated. Evidence shows this helps surgeons improve skills and share expertise. Surgery at one unit – Oxford’s John Radcliffe – was stopped as recently as 2010 after a spate of deaths.

But concerns about child heart surgery go back much further, with questions being raised ever since the Bristol scandal in the 1990s. The review does not apply to Scotland, where all children’s heart surgery is carried out in Glasgow. But it does affect families elsewhere in the UK. Some children in Northern Ireland travel to England for treatment, although many are seen in Belfast and Dublin, while families in Wales have surgery in England.’