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Hospitals to be told to 'stop child heart surgery' Hospitals to be told to 'stop child heart surgery'
(about 1 hour later)
By Nick Triggle Health reporter, BBC NewsBy Nick Triggle Health reporter, BBC News
Child heart surgery will stop at some hospitals to ensure patient safety under official plans put forward.Child heart surgery will stop at some hospitals to ensure patient safety under official plans put forward.
The NHS review looked at all 11 units in England amid concern expertise was being spread too thinly.The NHS review looked at all 11 units in England amid concern expertise was being spread too thinly.
It has proposed four options - all of which involve stopping operations at either four or five hospitals.It has proposed four options - all of which involve stopping operations at either four or five hospitals.
These are being considered on Wednesday by a special committee representing every NHS trust. It will decide which to put out to consultation. The proposals will now be put out for public consultation. A final decision will be made in the autumn.
One of the 11 - Oxford's John Radcliffe Hospital - has already stopped its operations. But it could be 2013 before all the units finally stop doing surgery.
The decision came after several deaths there last year. Although, one of the 11 - Oxford's John Radcliffe Hospital - has already stopped. The decision came after several deaths there last year.
In total, there are just 31 child heart surgeons across England. Between them, they carry out 3,600 operations each year on children in England and Wales, born with a range of heart defects.In total, there are just 31 child heart surgeons across England. Between them, they carry out 3,600 operations each year on children in England and Wales, born with a range of heart defects.
Most children survive to adulthood, but there is widespread agreement among professional bodies that to provide a uniformly high quality of safe service, operations must be concentrated in fewer, larger centres.Most children survive to adulthood, but there is widespread agreement among professional bodies that to provide a uniformly high quality of safe service, operations must be concentrated in fewer, larger centres.
Looking at the documents, one can't doubt the huge amount of work and analysis which has gone into this.Looking at the documents, one can't doubt the huge amount of work and analysis which has gone into this.
Each unit is rated in a number of different ways. And every unit, bar Oxford, continues to survive in at least one of the scenarios.Each unit is rated in a number of different ways. And every unit, bar Oxford, continues to survive in at least one of the scenarios.
But this may give false hope to units like Leeds, which looks very unlikely to retain its surgery status.But this may give false hope to units like Leeds, which looks very unlikely to retain its surgery status.
Some might argue that it would have been better for the review team to be more prescriptive and actually list the units they think should no longer do surgery rather than this variety pack scenario.Some might argue that it would have been better for the review team to be more prescriptive and actually list the units they think should no longer do surgery rather than this variety pack scenario.
This would enable surgeons to improve skills and share expertise.This would enable surgeons to improve skills and share expertise.
Concerns have been raised about child heart surgery ever since the Bristol scandal in the 1990s when children having heart surgery died needlessly.Concerns have been raised about child heart surgery ever since the Bristol scandal in the 1990s when children having heart surgery died needlessly.
Professor Roger Boyle, the government's heart and stroke tsar, said he had "no doubt" that change was necessary.Professor Roger Boyle, the government's heart and stroke tsar, said he had "no doubt" that change was necessary.
"Unfortunately the answer is not recruiting more surgeons to the current centres. That would be a recipe for disaster as surgeons would not treat enough children to maintain their skills.""Unfortunately the answer is not recruiting more surgeons to the current centres. That would be a recipe for disaster as surgeons would not treat enough children to maintain their skills."
The changes have also received the backing of doctors. A joint statement from the Royal College of Surgeons and the Society of Cardiothoracic Surgery said: "England has the right number of heart surgeons treating rare heart conditions in children, but we know that they are thinly spread over too many units.The changes have also received the backing of doctors. A joint statement from the Royal College of Surgeons and the Society of Cardiothoracic Surgery said: "England has the right number of heart surgeons treating rare heart conditions in children, but we know that they are thinly spread over too many units.
"A better service would be provided if this expertise were condensed in fewer units with the critical number of staff to support each other, disseminate new techniques and train the next generation of specialists.""A better service would be provided if this expertise were condensed in fewer units with the critical number of staff to support each other, disseminate new techniques and train the next generation of specialists."
VulnerableVulnerable
Anne Keatley-Clarke, chief executive of the Children's Heart Federation, which represents parents, said she agreed.Anne Keatley-Clarke, chief executive of the Children's Heart Federation, which represents parents, said she agreed.
"The majority of parents recognise that paediatric cardiac surgery is a specialist service that is best delivered on a national basis. So they support the concept of larger, but fewer centres of excellence and are willing to travel substantial distances for their child's surgery.""The majority of parents recognise that paediatric cardiac surgery is a specialist service that is best delivered on a national basis. So they support the concept of larger, but fewer centres of excellence and are willing to travel substantial distances for their child's surgery."
Nonetheless, local groups of opposition involving parents and MPs have started voicing criticisms about the prospect of losing local services.Nonetheless, local groups of opposition involving parents and MPs have started voicing criticisms about the prospect of losing local services.
The review, set up by the National Specialised Commissioning Group, which is in charge of child heart units, recommended a minimum of four surgeons per unit, which means at least four hospitals will stop doing operations.The review, set up by the National Specialised Commissioning Group, which is in charge of child heart units, recommended a minimum of four surgeons per unit, which means at least four hospitals will stop doing operations.
The 11 units under review are: Alder Hey in Liverpool, Birmingham Children's Hospital, Bristol Royal Hospital for Children, Evelina Children's Hospital in London, Freeman Hospital in Newcastle, Glenfield Hospital in Leicester, Great Ormond Street Hospital for Children in London, Leeds General Infirmary, Oxford's John Radcliffe Hospital, Royal Brompton Hospital in London and Southampton General Hospital.The 11 units under review are: Alder Hey in Liverpool, Birmingham Children's Hospital, Bristol Royal Hospital for Children, Evelina Children's Hospital in London, Freeman Hospital in Newcastle, Glenfield Hospital in Leicester, Great Ormond Street Hospital for Children in London, Leeds General Infirmary, Oxford's John Radcliffe Hospital, Royal Brompton Hospital in London and Southampton General Hospital.
All four options on the table involve hospitals in Birmingham, Liverpool's Alder Hey and Bristol continuing to do surgery along with two in London. Of the three sites in London, it seems certain Great Ormond Street will keep operating because of the other specialist services it has there.All four options on the table involve hospitals in Birmingham, Liverpool's Alder Hey and Bristol continuing to do surgery along with two in London. Of the three sites in London, it seems certain Great Ormond Street will keep operating because of the other specialist services it has there.
Stopping surgery does not mean the whole heart unit closes as they will still see patients for diagnosis, monitoring and non-surgical treatment.Stopping surgery does not mean the whole heart unit closes as they will still see patients for diagnosis, monitoring and non-surgical treatment.
The review's recommendations are now being discussed a special committee representing primary care trusts. This committee will decide which of the options to put forward for public consultation. The verdict is not due until 1700GMT, although they are expected to put forward more than one option. The review's recommendations were accepted for consultation at a meeting on Wendesday of a special committee representing primary care trusts.
Leeds and the Royal Brompton seem to be the most vulnerable with one of Leicester or Southampton likely to go too.
The review does not apply to Scotland, where all children's heart surgery is carried out in Glasgow.The review does not apply to Scotland, where all children's heart surgery is carried out in Glasgow.
Children from Northern Ireland have to travel to Dublin for surgery.Children from Northern Ireland have to travel to Dublin for surgery.
Children in Wales travel to England for surgery.Children in Wales travel to England for surgery.
Has your child had heart surgery? What is your reaction to this review? Send us your experiences using the form below. The four options are:
  • Newcastle, Liverpool, Leicester, Birmingham, Bristol plus two in London
  • Newcastle, Liverpool, Birmingham, Bristol, Southampton plus two in London
  • Newcastle, Liverpool, Birmingham, Bristol plus two in London
  • Leeds, Liverpool, Bristol, Birmingham plus two in London