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NHS England gives further detail of assurances needed for children’s heart surgery to restart next week

NHS England today gave further details of the assurances that are being sought to enable Leeds Hospital to restart children’s heart surgery next week.

It stressed the Trust’s decision to pause surgery was a prudent, precautionary step.

Since then a review, which started last week, has been look in detail into: mortality outcome data and analysis; staffing; patient concerns and complaints; and concerns raised by other professionals.

This information, alongside the latest position, was formerly reviewed yesterday at a risk summit that drew together all of the key bodies involved including the Trust, NHS England, the Care Quality Commission, the NHS Trust Development Authority and Leeds City Council.

Ian Dalton, the Deputy Chief Executive and Chief Operating Officer of NHS England, said: “The risk summit concluded that surgery could restart at the beginning of next week, subject to independent validation of the clinical data and an external review of clinical governance processes. We expect this work to be completed over the next few days and a conclusion reached early next week.”

He added: “I want to be absolutely clear that throughout this process the entire focus has been on the safety of children. We are working round the clock to resolve this matter as quickly as we possibly can. In the meantime we are ensuring that children can get the care they need elsewhere.”

The immediate process will involve:

  • The validation of the data provided yesterday by the Trust, which will be reviewed by independent clinical experts;
  • A review of clinical governance in the unit. The review team will aim to assess that the services available for paediatric cardiac surgery are of a standard consistent with other units in the country with a similar case mix. The evaluation will look in detail at current working practices, across paediatric cardiac surgery and intensive care. It will involve looking at details of the current protocols and policies within the unit and a review of any recent incidents or complaints with interviews with staff involved in the care of these children. This work will be led by independent clinicians.

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2 comments

  1. Angela Trinder says:

    Dear Deputy for NHS Medical Director, in the early hours of last night I watched Parliament from 5th March 2013, good job but you should have Sir Bruce Keogh and Sir David Nicholson to stop using drivel for their answers to the NHS Trust Public Inquiry. Can you not support us worried Grandparents of a heart warrior and ask for their resignations. Below is a summary of their deeds. He never actually answered your questions about 17 failing Trusts!

    Addressing the Reasons Why Children’s Heart
    Surgery at Leeds Was Suspended

    MORTALITY DATA

    Following detailed analysis over the few days it has been stated that Leeds is not an outlier, as was previously claimed by Professor Sir Roger Boyle and Professor Sir Bruce Keogh. Sir Bruce said on the BBC on Tuesday 9th April that the data was inaccurate. We would ask that this data be made public as soon as possible, along with the minutes from the last eleven days’ meetings, to ensure complete transparency.

    This follows sharp criticism from organisations responsible for producing reliable and informed statistics on mortality at the way Sir Bruce and Sir Roger sought to use these figures:

    1) John Gibbs, head of the Central Cardiac Audit Database (CCAD) sent an email to Professor Sir Roger Boyle on 28th March, copied to Professor Sir Bruce Keogh, in which he says:

    “Roger – I am truly appalled that this has happened in this way with no consultation with the congenital steering committee. As you well know, this is work in progress and we have not even got the data statistically analysed yet…”

    2) On April 1st, Dr Tony Salmon, president of the British Congenital Cardiac Association (BCCA) issued the following statement:

    “We are very concerned that some of this preliminary ‘raw’ data, which has not been verified, has entered the public domain before CCAD or any of the hospitals have had an opportunity to assess or ratify the information. As a result of the fact that the data has not undergone stringent checks, the suggestion that there is a higher than expected mortality rate in Leeds or any other centre, is premature…”

    STAFFING LEVELS

    Sir Roger is quoted as saying to The Independent newspaper that the service in Leeds “…was running on two junior locum heart surgeons.”

    The facts are that the Leeds unit has more consultant surgeons than any other centre in the North. The Guardian in an article on 4th April implied that there is some irregularity with an arrangement whereby a former Leeds consultant, now working abroad, returns to the city to operate one weekend a month. This arrangement was put in place to provide extra capacity to address the growing demand for children’s heart surgery at Leeds and this consultant is internationally renowned and well-known to many of our patients and families.

    All parties, including NHS England and the Care Quality Commission (CQC), are fully satisfied with staffing levels and quality at the Unit. All surgeons at the unit are highly qualified experts in their field and staff cover is as it should be for a unit of Leeds’s size, which is on course to deliver almost 400 surgical procedures a year.

    PATIENT CONCERNS

    All complaints received by Leeds Teaching Hospitals Trust and the CQC in recent weeks have been looked at and the CQC has found that there are no grounds to investigate further. Historically, over the last two years a handful of complaints have been received about the service at the Hospital. This amounts to one complaint per 2,000 patient contacts in total. These were previously investigated by the CQC; none led to material concerns about the quality of care; and no further action was required.

    ‘WHISTLE-BLOWER’ ALLEGATIONS TO PROFESSOR SIR BRUCE KEOGH

    All allegations have been fully investigated by the CQC over the last 11 days and no grounds for concern have been found. It is important to note that these so-called whistle-blowers include staff at Newcastle’s children’s heart surgery unit and Sir Roger Boyle, all of whom have an obvious interest in seeing the Leeds Unit close as per the outcome of the now discredited Safe and Sustainable Review.

    ALLEGATIONS BY THE CHILDREN’S HEART FEDERATION

    In relation to the allegations made by Anne Keatley Clarke, chief executive officer of the Children’s Heart Federation, Ms Keatley Clarke has made other, unfounded allegations against the Leeds Unit in the past. These were investigated and found to be without substance. Of the recent complaints that she has taken to the media, Ms Keatley Clarke has described them as having been made on “very, very soft evidence”. We are inviting Ms Keatley Clarke to share evidence about her concerns so that they can be fully investigated – ideally, before she announces them through other channels. It is also important to note that Ms Keatley Clarke was a member of the Safe and Sustainable Review steering group which recommended the closure of Leeds in favour of Newcastle. She was censured for her behavior as a member of that steering group.

    BIASED EXPENDITURE BY NHS SPECIALISED SERVICES

    NHS Specialised Services undertakes the commissioning of highly specialised services at a national level for people with very rare conditions and is the arm of the NHS which ran the Safe and Sustainable Review. Its various sub-organisations, such as the Advisory Group for National Specialised Services (AGNSS), acted as advisers to the Review and decision-makers. Since 2004-05, it has funded the hospital trusts in the North East of England to an extraordinary extent. The following table shows expenditure on nationally commissioned NHS services per head of population for each English region. This focusses attention on the point that having pumped such a disproportionate amount of money into the North East, NHS bosses then had to ensure that the Newcastle Unit remained sustainable, even if this meant denying patients a choice and forcing them to go to Newcastle for treatment.

    Please help other MP’s like Greg Mulholland & Co from Yorkshire as part of the Health Committee,
    Kind regards, Angela & Steve

  2. Fragile Hearts says:

    How can this be done in two days? As a group representing parents affected by negligent care we would hope to see all this properly investigated. Rather than rushed to please the politicians. We seek assurances that full raw data is given to independent experts such as Jarman or Spiegalhater.