Row grows over decision to shut Leeds Infirmary's heart unit
Children's cardiac centre deaths only 'a little high', says expert, as faulty data blamed for closure
A bitter row over a decision to suspend children's heart surgery at Leeds General Infirmary was further inflamed yesterday after an expert in health statistics said the death rate at the hospital was only marginally higher than at similar centres.
Professor Sir Brian Jarman, who co-founded the health statistics and research service Dr Foster, yesterday said the latest information suggested the death rate at LGI was "a little high". But he added: "It is not significantly higher than other units." Professor Jarman, one of Britain's foremost hospital data analysts, publishes the Hospital Standard Mortality Rates that helped to expose the Mid Staffordshire scandal and prompted investigations into a further 14 trusts. He said the data he had examined was as recent as February, but added that he had not be able to obtain the data the NHS says it relied on to make the suspension decision. "It ought to be in the public domain," he said.
His comments yesterday appeared to support to claims from doctors working at Leeds General who insist the data used by the NHS was incomplete. Elspeth Brown, a cardiologist, has repeatedly claimed the closure decision was based on incomplete information. Dr Brown complained that data showing "higher than expected" mortality rates failed to include one in three operations at the cardiac unit, which carries out about 400 operations on children a year.
The medical director of the NHS, Sir Bruce Keogh, provoked furious protests from campaigners last week, when he suspended heart surgery in the children's unit while a review is carried out. The announcement came a day after a High Court judge ruled the consultation over changes to children's heart surgery in England and Wales – which earmarked the Leeds unit for closure – was flawed.
Hospital chiefs said they hoped the internal review would be completed in three weeks. But the "pause" will leave dozens of sick children facing longer waits for vital treatment, and could ultimately mean they are forced to travel elsewhere for surgery.
Sir Bruce said the mortality figures, which came to light shortly after the court ruling, were among a "constellation of reasons" behind the decision. He said he had also received "disturbing" calls from two whistleblowers, and an "agitated senior cardiologist" who had preliminary data showing that the unit's mortality rates were considerably higher than at comparable centres.
Professor Sir Roger Boyle, director of the group overseeing mortality data across the health service, yesterday backed the closure decision, revealing that two "relatively junior surgeons" had been left in charge of the unit. "The background to this was that Leeds had already suspended one surgeon because of unacceptable mortality rates [and] the senior surgeon was away on holiday. That left two junior locum surgeons, relatively inexperienced, holding the fort," he said.
But Dr John Gibbs, chairman of the Central Cardiac Database, which produced the controversial figures used to justify the suspension, said the data was "not fit to be looked at by anyone outside the committee". "It was at a very preliminary stage, and we are at the start of a long process to make sure the data was right and the methodology was correct. We would be irresponsible if we didn't put in every effort to get the data right. It will cause untold damage for the future of audit results in this country. I think nobody will trust us again. It's dreadful."
Dr Brown, who is a consultant cardiologist at Leeds Teaching Hospitals NHS Trust, said the unit must be allowed to resume children's heart surgery. She said: "We do now know that the figures that were presented... were simply wrong, they... did not include all the operations in Leeds, and they had then been subject to some statistical analysis which generated this headline figure. We've been looking very hard at the figures over the last three years and we are confident our mortality figures are well within what would be expected. All the clinicians in Leeds are very happy with our figures at present." She added: "We need... people to stop attacking us and we need to resume surgery as soon as possible."
Concerns about death rates at the hospital were first raised by the Children's Heart Federation two years ago. The Care Quality Commission reported there had been 20 unexpected deaths over the eight-year period to 2008.
But an NHS review which concluded the hospital should stop cardiac surgery – along with units in Leicester and London – to concentrate services at larger centres, sparked protests. More than 600,000 signed a petition calling on the Government to keep the Leeds unit open.
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