Royal colleges have united in their condemnation of the High Court’s decision to find the review of paediatric heart surgery “unlawful”.

The Royal Brompton recently won its judicial review into the decision to close its paediatric heart surgery unit, undermining the validity of the national consultation on service reconfiguration.

The west London hospital challenged the way the consultation was carried out by a Joint Committee of Primary Care Trusts. As a result of the ruling being upheld, the wider consultation will almost certainly have to be carried out again.

The move was part of wider consolidation of moving surgery to fewer sites across England.

However, in a letter to The Guardian, the Royal College of Surgeons, the Royal College of Paediatrics and Child Health and the Royal College of Nursing express “disappointment” in Mr Justice Owen’s decision.

They say: “This review was not undertaken lightly and never before have we been so close to achieving real change. It is frustrating that we find ourselves facing a further wait. The fact is we have too many surgeons spread too thinly across numerous hospitals. Concentrating clinical expertise into larger, specialist centres and developing networks of expert cardiology care will give children born with complex heart conditions the best quality of care.

“These children shouldn’t have to wait any longer for urgent changes to be made to services.”

The review has been halted because assessment of the Royal Brompton’s research programme was bungled.

According to Justice Owen, the consequence was to “…seriously distort the consultation process. Those responding to the Consultation Document would inevitably have proceeded on the premise that the RBH Trust’s capacity for research and innovation was poor.”

The letter in The Guardian acknowledges “Brompton’s disappointment” but continues “we need to look to sustain a high-class, sustainable service capable of delivering optimum training in the future. Changing services is not easy, but the NHS must continue its vital work and make decisions as a matter of urgency to ensure better outcomes for children with congenital heart disease in the future.”

It is signed by Professor Norman Williams, president of the Royal College of Surgeons, Dr David Shortland, vice-president of the Royal College of Paediatrics and Child Health, and Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing.

Mr Bob Bell, chief executive of Royal Brompton & Harefield NHS Foundation Trust, said: “The position of our trust remains that the number of paediatric cardiac surgery patients in London and the South East warrants a paediatric network system, comprising the three current outstanding centres, each of which offers a different but complementary model of care, admired in many parts of the world.

“We already work closely and successfully with both Great Ormond Street and Guys and St Thomas’s. There is more that can be done, indeed must be done, as we strive to find a solution for the implementation of such a system.”

The Royal Brompton has won its judicial review into the decision to close its paediatric heart surgery unit and thrown the validity of the national consultation on service reconfiguration into doubt.

The west London hospital challenged the way the consultation was carried out by a Joint Committee of Primary Care Trusts. As a result of the ruling being upheld, the wider consultation will almost certainly have to be carried out again.

The move was part of wider consolidation of moving surgery to fewer sites across England.

The judgement, by Mr Justice Owen, centred on the assessment of Royal Brompton’s ‘research and innovation’ score in the exercise that determined which centres were included in the options to be put to public consultation. Two separate analyses of each centre were undertaken as part of the Safe & Sustainable programme. The first included self-assessment exercises and visits to all centres from an independent panel led by Sir Ian Kennedy.

The second ‘configuration evaluation’ was carried out some months later by management consultants KPMG, and was used to identify suitable configurations of surgical centres around the country. These configurations became the four options in the public consultation (A-D).

The assessment stage concentrated on the safety and sustainability of each centre and did not ask centres for, or include an evaluation of, paediatric cardiac research output and quality (its main focus being clinical services). So, detailed information on Royal Brompton’s paediatric cardiac research output and programme was not supplied, because it was not asked for.

It was not until a public meeting in February 2011, that representatives from the hospital became aware that a score which rated Royal Brompton’s paediatric cardiac research programme had been used during the second ‘configuration evaluation’ exercise. On investigation it became apparent that this score had been determined using information supplied for the first, unrelated assessment, despite the fact that it had been made clear that the two would be separate exercises.

No specific information on the hospital’s paediatric cardiac research programme had ever been requested and without the benefit of relevant information, a low score was given.

According to Justice Owen, the consequence was to “…seriously distort the consultation process. Those responding to the Consultation Document would inevitably have proceeded on the premise that the RBH Trust’s capacity for research and innovation was poor.”

Mr Bob Bell, chief executive of Royal Brompton & Harefield NHS Foundation Trust, called it an important day for the whole of the NHS.

He said: “The real tragedy is that the judicial review could and should have been avoided. It was obvious to us from the outset that there were errors in the Safe & Sustainable process and we made Sir Neil McKay, chair of the Joint Committee of Primary Care Trusts, aware of our concerns. His refusal to consider these issues left legal challenge the only option open to us.

“The position of our trust remains that the number of paediatric cardiac surgery patients in London and the South East warrants a paediatric network system, comprising the three current outstanding centres, each of which offers a different but complementary model of care, admired in many parts of the world. We already work closely and successfully with both Great Ormond Street and Guys and St Thomas’s. There is more that can be done, indeed must be done, as we strive to find a solution for the implementation of such a system.”

The court bid - brought by the Royal Brompton and Harefield NHS Foundation Trust - represented the first time that one NHS organisation has taken legal action against another.

The Royal College of Surgeons said the decision by the High Court to find the review ‘unlawful’ was disappointing.

Professor Norman Williams, president of the Royal College of Surgeons, said: “While it would be understandably disappointing for those high-performing units that would need to close as a result of the review, these decisions have to be been taken in the very best interest of the patients involved.

“Surgeons agree that a comprehensive, stable and safe children’s heart surgery services would be best delivered in fewer centres staffed by a minimum of four surgeons who are able to offer 24 hour care and support for each other.  It is deeply concerning that a national issue with widespread support from the profession can be held up in this way. ”