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Reports into safety at region's child heart surgery unit

Campaigners fighting to save the region's only children's heart surgery unit say two far-reaching reports vindicate their claims that the unit is, and always has been - safe.

The reports out today looked at the treatment of 14 patients over a 10 year period at the Leeds General Infirmary, along with the temporary suspension of operations last year. And they concluded that the unit is well-run and in a position to go from strength to strength. Tina Gelder reports

Children's Heart Surgery Fund respond to reports

ABOVE: Sharon Cheng, Children's Heart Surgery Fund

Campaigners fighting to save one of the region's heart surgery units say two far-reaching reports vindicate their claims that the unit is, and has always, been safe.

The reports looked at the treatment of fourteen patients over a ten year period at the Leeds General Infirmary, along with the temporary suspension of operations last year. They conclude the unit is in a 'well-run' position.

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Children's Heart Surgery Fund welcomes new report

“The Verita report finally provides the balanced investigation and viewpoint that clinicians and families have been waiting for. The report’s findings confirm that the Leeds unit is safe and provides excellent standards of clinical care, treatment and outcomes for the children under its care.

“Verita’s analysis makes clear that many of the claims and accusations that led to the suspension of surgery and the subsequent unbearable scrutiny of the Leeds unit were unfounded or incorrect, and in some cases were made due to vested interests. It is important to note that of the final 17 recommendations made, only one refers specifically to Leeds about communication. The rest are general points for all units.

“We understand the need to act on any concerns about healthcare provision in the UK. However, the need for swift action should not negate the processes designed to ensure that concerns are valid and safeguard patients. We believe that NHS England has put new processes in place to ensure that this type of action, which is so damaging to patient and staff confidence, never happens again. We would ask them to ensure that these processes are followed, without exception.

“The report also supports CHSF’s view at the time that that the second stagePatient Experience review presented a distorted view of standards at Leeds. It states that the terms of reference made it inevitable that the report would be one-sided and it accepts that it did not allow responses to the concerns expressed.

“This report concludes that the Safe & Sustainable cardiac review pitted units against each other and created a climate of fear and uncertainty. The whole sad affair of the last 18 months has been a symptom of this. Verita recommends that current or future reviews actively seek the input of all relevant stakeholders, notably families and their representatives. We support this wholeheartedly and would ask that the new review go to every length to comply with this recommendation.

“Ten thousand patients pass through the Leeds unit every year, and the overwhelming majority experience excellent service and treatment. Unfortunately, the families and patients that we hear from every day who are overwhelmed with the care they receive from Leeds have not had a voice in this process. However, they tell us that care and medical treatment at Leeds is exemplary, and the report supports their experience. Certainly, there were a handful of cases that had issues with communication or process, and Leeds will learn from these. However, it’s impossible to imagine that any other unit would not also have similar complaints upheld had they undergone the same level of scrutiny.

“Success rates in this speciality, both at the Leeds unit and nationally, stand at 98.2 per cent, an incredible statistic when dealing with such a complex speciality. Leeds is now performing more than 380 children’s heart procedures per year. Its outcomes and quality of care are in line with national requirements and those of other units, and parents can feel 100 per cent confident in the treatment that their children will receive at Leeds. This report gives us closure – let’s now move on for the sake of our families and clinicians.”

– Children’s Heart Surgery Fund Statement

Hilary Benn responds to Heart Unit review

“It’s taken a long time to get to this point, but this is now the final chapter in an unhappy episode.

“It was clear at the time that children’s heart surgery in Leeds was safe to continue; as the mortality review found, medical and surgical care at Leeds was “in line with standard practice”. Now in these latest reports we have had it confirmed that there was “no evidence that Leeds was unwilling to make referrals to centres outside Yorkshire, nor that it was unwilling to refer to Newcastle”.

“There are of course lessons to be learned, particularly around communicating with parents at what is a very stressful time for them and their children, but let’s now put the past behind us and support all the staff as they continue to offer the best possible care to very sick children.”

– Hilary Benn, Labour MP for Leeds Central

Leeds Heart Unit has made 'improvements'

Improvements have been made at a children's heart surgery centre that was temporarily closed last year due to fears over mortality rates, an independent review has found.

Paediatric cardiology at Leeds General Infirmary (LGI) was closely scrutinised and it is well-run and in a position to "go from strength to strength", a senior NHS director said.

The controversy over the heart unit was set against a background of concerns raised by surgeons in Newcastle about the care provided in Leeds, at a time when the future of both units was under discussion.

Children's heart surgery was halted for more than a week in March last year at Leeds before the all-clear was given to resume.

Independent reviews of three areas were commissioned - the Leeds unit's mortality rate, the experience of some families and 14 cases highlighted by Newcastle staff.

A review of all aspects, published today, has made 17 recommendations to improve care which should be adopted nationally.

NHS England's deputy medical director, Dr Mike Bewick, said: "Patients should be reassured that this service has been rigorously scrutinised and has improved as a result.

"Patients and the public can have confidence that this is a well-run unit and is now in a position to go from strength to strength. "Not only have we learned about service in Leeds we have learned lessons of relevance nationally.

"We are currently consulting on new standards for children's heart surgery across the country and the review in Leeds has made a significant contribution."

Dr Bewick added: "This thorough process would not have been possible without the full co-operation and participation of patients, families and clinicians.

"Reliving painful events or opening oneself up to public scrutiny is not easy. "This review has been characterised by the willingness of individuals and organisations to do just that."

The report recommends improvements should be made to record keeping, communicating with families, managing consultations on major reconfigurations, whistleblowing and on improving trust in the service.

The Children's Heart Surgery Fund, a charity which supports the Leeds unit, welcomed the review's findings. Chief executive Sharon Cheng said: "The report's findings confirm that the Leeds unit is safe and provides excellent standards of clinical care, treatment and outcomes for the children under its care."

She said plans to streamline cardiac services nationally "pitted units against each other and created a climate of fear and uncertainty". She added: "The whole sad affair of the last 18 months has been a symptom of this."

And she said: "Success rates in this speciality, both at the Leeds unit and nationally, stand at 98.2%, an incredible statistic when dealing with such a complex speciality.

"Leeds is now performing more than 380 children's heart procedures per year.

"Its outcomes and quality of care are in line with national requirements and those of other units, and parents can feel 100% confident in the treatment that their children will receive at Leeds.<

"This report gives us closure - let's now move on for the sake of our families and clinicians."

Newcastle upon Tyne Hospitals NHS Foundation Trust said the changes already brought in justified the critical comments staff made about Leeds.

It stated: "We can give a categorical assurance that our aim then, as it is now, reflects an unstinting commitment to improve pathways of care including choice where appropriate."

The LGI unit had been earmarked for closure, along with two others in Leicester and the Royal Brompton in west London as part of a nationwide plan to streamline children's cardiac surgery into fewer, more specialised units.

But, after a fierce campaign by some parents whose children were treated at the LGI and two legal challenges, Health Secretary Jeremy Hunt halted the plan and ordered NHS England to re-evaluate the whole process.

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NHS to consider grounds for appeal

Sir Neil McKay CB, Chair of the Joint Committee of Primary Care Trusts, said:

Following today’s ruling, we are strongly considering our grounds for appeal. The NHS remains as determined as ever to reconfigure children’s heart services. The NHS will of course study the ruling carefully and its implications. The Judge was very clear that she was not advocating a return to the start of the review process. I am pleased that the Judge has upheld our decisions in relation to the quality standards and the model of care.

We will give due consideration to the judgment and will advise people of the next steps in the process at the beginning of April. We will aim to reach a final decision in June 2013, pending the outcome of the separate IRP process. The expert view remains that the longer vested interests delay this process, the greater the risk of safety concerns manifesting in the units.

I never forget that the purpose of our work is saving lives and improving quality of life for children, and on behalf of the NHS I want to reassure families, patients and clinicians that we remain as determined as ever to reconfigure services for children with congenital heart disease in the interests of better outcomes and a more safe and sustainable service for children and their families. The decision we took in July last year will help save children’s lives, reduce co-morbidities and ensure ongoing care is provided closer to many families’ homes.”

– Sir Neil McKay CB, Chair of the Joint Committee of Primary Care Trusts,
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