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The new Congenital Heart Disease review: 16th update – John Holden

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In the comments section of the blog and elsewhere, we’ve been asked what the review team will do about quality or safety concerns in any of the units currently providing congenital heart care. This is a big question with at least three distinct dimensions: first, the potential impact of continuing uncertainty on the quality of service provided by units; second, the way that we deal with any safety concerns raised with us in the course of the review; and third, the way that specialised services are commissioned and the steps NHS England will take as a commissioner to assure the quality and safety of those services. I will return to this topic in a future blog. For now, I want to make two specific points:

  • There is a balance to be struck between acting quickly to stabilise a vulnerable service, versus spending enough time to conclude a review with sufficient engagement and ownership of the outcome so that it has a good prospect of successful implementation.   If you have heard me speak at a meeting you will know that I make this point every time I’m on my feet – there is no “right” answer and we are striving to get the best balance we can between pace and inclusivity. I do not want the review to become part of the problem, prolonging the “limbo”, but we only took on this responsibility in June 2013 and to simply continue where the last review left off would be unacceptable.
  • We have a clear policy for dealing with any quality or safety concerns raised with us during the course of our review.  I described this in blog 4, [26 July 2013]. We will always work with our national safety director and our area teams to make the Care Quality Commission (CQC) aware of these concerns: CQC host the Chief Inspector of Hospitals and have legal powers to assure essential levels of safety and quality.

Patients, families and their representatives

As I mentioned in the my last blog, Michael Wilson, Claire McDonald (our engagement adviser) and I held a meeting in Birmingham on 8 January 2014 to which we invited all those local authorities who host a congenital heart surgical centre, and representatives from national and local Healthwatch organisations. Outputs from that meeting (including a list of those people who attended) are now available here.

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The next meeting of our Patient and Public Group is on 10 February 2014 in London.

Clinicians and their organisations

The Provider Group (engagement with Chief Executive and other senior leaders of provider organisations) met in London on 15 January 2014. The slides we used for this meeting are available here. We will provide a write up of the meeting shortly.

The next meeting of the Clinicians’ Group is on 30 January 2014 and a copy of the agenda is available to view here.

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Professor Deirdre Kelly, who is chair of our Clinicians’ Group, is making arrangements to visit each of the congenital heart units during the spring. She will be accompanied by Michael Wilson and/or other members of the review team. The purpose of the visits is simply to help Professor Kelly and colleagues to better understand the work of the units. The visits are NOT in any way a part of assessing, scoring or otherwise judging the performance, suitability or prospects of the units.

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NHS England and other partners

On 9 December 2013, NHS England invited patients, patient groups, commissioners, clinicians and others to a special event on the future of specialised services as part of its wider ‘Call to Action’ project, which was launched in July 2013. A full report of the key themes which emerged during that event is now available to download. This will inform the development of a five year strategy outlining how specialised services are best provided to improve patient experience and outcomes, against a backdrop of financial challenges and rising demand. The detail of the strategy, taking account of this report, will be developed in early 2014.

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The DRAFT minutes of the Board’s Task and Finish Group meeting on 7 January 2014 are now available.

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NHS England’s Board held its regular meeting in public on Friday 24 January 2014 in London. One of the items considered was the routine update from Board Committees, including the new CHD review’s “Task & Finish Group”. A  copy of the relevant Board paper is here, and a video recording of the discussion will be available shortly on the relevant section of the NHS England website.

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The next meeting of our Programme Board is on 11 February 2014 and the agenda and papers for this meeting will be available on our webpages in due course.

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One comment

  1. Nick de Naeyer says:

    It is around 20 years since the Bristol scandal, and 5 years since the Safe & Sustainable review was started. I have a mother of a beautiful baby girl who died of a CHD last week, barely 9 months old. When can I tell her that the talking has stopped and the action to improve the service begins?
    All the units have already been visited and assessed, patient/public feedback has been given, and a recommendation was arrived at. You should be fine tuning, not reworking. The time for implementation is now.
    The bottom line is, some babies are dieing, that could have been saved.