Hospital Dr News

Final decision made on paediatric heart services

The Royal Brompton in London and hospitals in Leicester and Leeds are to lose units as part of a national review of paediatric heart services in England.

The number of hospitals performing complex cardiac paediatric surgery is being reduced from 11 to seven – the John Radcliffe in Oxford stopped following unexpected deaths in 2010.

The final reconfiguration decision has taken 10 years, with the Royal Brompton fighting hard to avoid closure of its unit and losing a judicial review in the high court.

The Joint Committee of Primary Care Trusts (JCPCT) approved a plan earlier this week to reduce the number of centres offering children’s heart surgery in London from three to two, with specialist heart and lung centre Royal Brompton Hospital, losing out to the Evelina Children’s Hospital and Great Ormond Street Hospital for Children.

“It is very difficult to know what to say at times like these,” said Royal Brompton & Harefield NHS Foundation Trust chief executive, Bob Bell. “But it is even more difficult to try and understand how this committee could have come to such a decision.”

As part of the proposals, the Royal Brompton will also lose its children’s intensive care unit which the trust claims will in turn destroy its world-class paediatric respiratory service, which specialises in the treatment of children with cystic fibrosis, severe asthma and a number of other severe and complex respiratory conditions.

Without the back-up of intensive care and on-site anaesthesia, Royal Brompton clinicians will not be able to undertake the more complex specialist treatments they do now, because they consider it unsafe to do so, Bell said.

Leeds General Infirmary and the Glenfield hospital in Leicester also lose their children’s heart surgery units. The hospitals, however, are intended to remain as networks for cardiology services, where children will be seen and assessed for operations.

“This is a landmark decision that clinicians and patients have long called for which will enable the NHS to improve care for children with congenital heart disease,” said Sir Neil McKay, JCPCT chairman.

“The needs of children, not the vested interests of hospitals, have been at the heart of this review. We only took the decision today after undergoing a robust, fair and transparent process which has already withstood the scrutiny of the highest courts in the land. Before making our decision, we carefully considered the responses to public consultation and all the available evidence and advice.”

Great Ormond Street Hospital, which has five paediatric cardiac surgeons on site and carries out more than 600 cardiac surgical procedures each year, welcomed the decision.

A spokesperson said: “We support the view that fewer, larger centres carrying out cardiac surgery will mean better outcomes for patients, with local centres continuing to provide follow up appointments close to the patients’ home.

“The hospital will now work closely with other designated centres and hospitals affected by today’s decision to ensure that there is a smooth transition for patients and their families to the new arrangements.”

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