Anger as child heart ops are axed

The closure of the Royal Brompton unit is part of plans aimed at streamlining paediatric heart services.

Managers at a hospital at the centre of a bitter legal row over plans to streamline paediatric heart services said they were baffled at today's decision to stop it performing heart surgery on children.

The Royal Brompton in Chelsea, west London, is one three specialist units in England which are to stop performing such procedures. There are 10 nationwide.

The hospital is the largest specialist heart and lung centre in the UK and among the largest centres in Europe.

Royal Brompton & Harefield NHS Foundation Trust chief executive Bob Bell said he was struggling to "understand how this committee could have come to such a decision".

He said: "I will now discuss this decision with the trust's board and governors' council to determine our next steps. One thing is certain - I will not be asking them for the mandate to manage the destruction of a highly valued and respected children's unit."

In November, the hospital won a High Court action against the Joint Committee of Primary Care Trusts (JCPCT), who carried out the consultation - the first time one NHS organisation had taken legal action against another.

But the ruling was overturned but the Court of Appeal in April and today the JCPCT said the Royal Brompton's, Leeds General Infirmary's and Glenfield Hospital in Leicester's units are to stop providing the surgery.

However, this will not happen immediately as plans to implement the new streamlined service are still being developed.

The move comes after an NHS review which concluded that expertise was spread too thinly in the 10 sites and should be concentrated in fewer hospitals.

It is understood that implementation of the streamlined services is expected to take place throughout 2013.

The Royal Brompton had been at the centre of a bitter legal dispute surrounding the consultation process, arguing that it was unlawful.

The hospital, which is the largest specialist heart and lung centre in the UK and among the largest centres in Europe, said that the proposals could put its future in doubt, but judges ruled that the consultation process was fair.

A spokeswoman from the hospital said as a result of the decision, the Royal Brompton would also lose its children's intensive care unit.

Meanwhile, the decision to close down the Leeds site was described as "perverse".

Mike Collier, chairman of Leeds Teaching Hospitals NHS Trust, said: "This result flies in the face of logical health care planning and plain common sense.

"We genuinely believe that the decision will not deliver the stated aims of the Safe and Sustainable Paediatric Cardiac Services review.

"This decision seems almost perverse in light of the information which became available during the course of the consultation process. We are surprised that the very clear wishes of over 600,000 people from this region appear to have been disregarded.

"On geography and population density alone the case for Leeds remains as strong as ever. We will now carefully consider, with our supporters, what action to take as a result of this very disappointing decision."

The consultation process was launched by the Joint Committee of Primary Care Trusts of England as part of a national review aimed at streamlining paediatric congenital cardiac surgery services (PCCS).

The Safe and Sustainable review followed the landmark inquiry into children's heart surgery at Bristol Royal Infirmary between 1990 and 1995, where up to 35 children and babies died as a result of poor care.

In the wake of the inquiry, it was recommended that paediatric cardiac units be set a target for the number of operations per year, and surgery be concentrated in a few specialist centres in order to ensure quality of care.

The institutions which will now house the specialist surgery centres are Evelina Hospital, which is part of Guy's and St Thomas' Hospital Trust and Great Ormond Street, both in London; Southampton General Hospital; Birmingham Children's Hospital; Bristol Royal Hospital for Children; the Freeman Hospital in Newcastle; and Alder Hey Children's Hospital in Liverpool.

The Children's Heart Surgery Fund said it would attempt to appeal against the decision.

Charity director Sharon Cheng said: "Today was a rubber-stamping exercise. The panel has listened to clinicians and doctors and ultimately decided doctors know best.

"Clinical logic has not been taken into consideration. They have ignored co-location. They have ignored patient choice.

"We will now appeal to the health minister as he assured us a decision would be made on clinical logic. This has not happened today."

But the Children's Heart Federation welcomed the move.

Chief executive Anne Keatley-Clarke said: "The delays to planned improvements in children's heart services caused a great deal of uncertainty for parents and professionals, so we are pleased for them that this has come to an end."

Great Ormond Street Hospital for Children NHS Foundation Trust was also in favour.

Sir Neil McKay, chairman of the Joint Committee of Primary Care Trusts, said: "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.

"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."

Once they stop providing surgery the units will still see patients for diagnosis, monitoring and non-surgical treatment.

John Radcliffe Hospital in Oxford was originally part of the consultation process but it suspended its children's heart programme in 2010 following a spate of deaths.