Closure of three children's heart surgery units provokes outrage

NHS confirms number of specialist hospitals will be cut to seven after landmark decision

Children’s heart surgery will be confined to seven hospitals from next year following a landmark decision to make care safer and better by closing some existing services.

Families in Leeds, Leicester, west London and Oxford were last night mourning the demise of their surgical centres where the lives of loved ones had been saved.

The long-awaited decision comes more than a decade after a landmark inquiry into the Bristol babies’ scandal ruled that it would be in the best interests of patients to concentrate services in far fewer hospitals.

It means babies born with serious heart defects in some parts of England and Wales will have to travel further for surgery than they do currently. They will be treated in bigger, 24/7 centres, with specialist surgeons performing more complex operations every year.

The review, which has been done without political involvement or interference, is the first of its kind in the NHS where clinically justified closures often trigger local MPs to get out their placards.

Medical experts hope that this decision, as drawn out and difficult as it has been, will pave the way for other conditions which would benefit from having fewer, larger, and more specialist centres.

The Royal Brompton hospital, which had earlier tried to derail the process by suing the NHS after it was identified as the preferred ‘loser’ in London before the end of the consultation, last night said the decision was incomprehensible. The Royal Brompton fears the decision, which will see its intensive care unit close, will destroy it world-class respiratory service as well.

Members of the Joint Committee of Primary Care Trusts (JCPCT), set-up for the review, last night decided to save Evelina Hospital, which is part of Guy's and St Thomas' Hospital Trust and Great Ormond Street in London. The Freeman Hospital in Newcastle, Birmingham Children's Hospital, Alder Hey Children's Hospital in Liverpool, Southampton General Hospital and Bristol Royal Hospital for Children, have also been chosen.

The committee has assessed each against a set of quality and safety standards and heard from more than 70,000 members of the public.

An 11th, John Radcliff hospital in Oxford was forced to drop out of the race in 2010 after children’s heart surgery was suspended because of safety concerns.

While only a few hospitals will be offering heart surgery, children will still have access to all other services closer to home for on-going care. None of the cardiac departments will close. They will instead focus on providing diagnostics, monitoring and non-surgical interventions, and there will be more specialist nurses and doctors trained to cope.

The Safe and Sustainable review into children’s cardiac surgery was announced by the NHS medical director in 2008 after all 11 hospital trusts agreed that it was high time for change.

At that time, there were 31 surgeons performing around 3,600 operations every year. Some had only two surgeons, too few to provide 24/7 cover, or train juniors, and rates of cancellations were as high as 10 per cent.

But despite the consensus, the review turned ugly and emotional at times as nobody wants to see their hospital close.

The Royal Brompton NHS Trust in London became the first NHS organisation to sue another NHS organisation after it alleged that the consultation process was unlawful and “a classic backroom stitch-up”

The Royal Brompton, which is the largest specialist heart and lung centre in the UK and among the largest centres in Europe, initially won, but the decision was overturned by the Court of Appeal in April.

Marie Edwards, whose baby daughter Jazmine died as a result of poor care at Bristol Royal Infirmary in 1993, said she was "flabbergasted" the reorganisation had taken so long.

Ms Edwards said: “If this had been done sooner children's lives would have been saved… I believe it has got a political edge to it. MPs were too scared to close units in their local constituencies. It is horrendous.”

Case study

Caroline Mutton's son Oliver, three, has a congenital condition which causes the blood to flow incorrectly through his heart. Oliver visits outpatient services at the Royal Brompton four times a year

"I am upset beyond belief at the decision to close services at the Royal Brompton. I would like Oliver to be cared for in a place he knows and can be cared for into adulthood. They say outpatient services will remain but we fear cardiac centres that lose surgical services will become second tier. Personally, closure means Oliver's cardiac care decisions may move to Birmingham and for respiratory care we will probably have to go to Great Ormond Street. The poor kids that come to the Royal Brompton with respiratory disorders will be shunted all over London. As this plan is implemented I expect they will see the impact it has on cardiac and respiratory care and reverse the decision. We will carry on fighting."

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