The new Congenital Heart Disease review: 17th update

Since the publication of this blog John Holden has left NHS England.

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I am often asked whether NHS England can accelerate work on the new review. With this in mind, we are always looking at ways to do several tasks at the same time. This could really help, so long as we avoid the mistake of prejudging the outcome (e.g guessing what we might hear from our consultation before it is complete). BUT – what we can’t do is simply tweak the conclusions of Safe & Sustainable, which were overturned by the courts, criticised by the Independent Reconfiguration Panel, and which the Secretary of State said could not be implemented. We have had to start again, and make a fresh appraisal of any of the Safe & Sustainable work that we want to build on.


Over the last few blogs I have kept you up to date with the evidence gathering and analysis we are undertaking as part of this review. We have made further progress on our commission for NICOR, the literature review, and our own activity analysis. An update, including some very early findings, was presented at the Patient & Public Group meeting on 10 February (see link to slides below) . This will also be discussed at the Programme Board on Tuesday 11 February 2014 under Item 7 (see link to papers below).

The ScHARR team undertaking our literature review are beginning their search for papers and their full proposal can be found here, but in summary they are focusing on the following two questions:

  1. What is the current evidence for the relationship between institutional and surgeon volume and patient outcomes and how is that relationship influenced by complexity of procedure and by patient case mix?
  2. How are patient outcomes influenced by proximity to/co-location with other specialist clinical services (e.g. co-location of services such as specialist cardiac paediatric intensive care)?

If you know of any relevant papers, please provide us with the full references by email to – as soon as possible, preferably by Monday 17 February 2014


Patients, families and their representatives

The Patient and Public Group met in London on 10 February 2014 and the agenda for the meeting is available here. The slides used for this meeting are available here and we will provide a write up of the meeting shortly, with a list of attendees.

Clinicians and their organisations

The Clinicians’ Group met in London on 30 January 2014 and the slides we used for the meeting are available here. We will provide a note of the meeting shortly, with a list of attendees.


NHS England and other partners

The next meeting of our Programme Board is scheduled for Tuesday 11 February 2014 and the agenda and papers for the meeting are available here. In addition to the paper (Item 7) regarding our analytical work mentioned above, I would also like to draw your attention to the paper (Item 5) entitled “from draft standards to agreed specifications”. This paper provides an update on progress to date in developing a set of standards to be incorporated into our commissioning specification, for full public consultation in late spring.


Our Board Task and Finish Group meeting due to take place on 12 February 2014 has been cancelled; the meeting will be rescheduled.


NHS England will shortly consult on a service specification for “cardiac surgery” – probably late February 2014. You could be forgiven for thinking this is the output of our review of congenital heart disease services, but IT IS NOT.  Instead, this specification outlines the service that all providers of cardiac surgery are expected to offer to their patients.  We expect to consult on our service specifications for congenital heart disease in June 2014. You will hear more about this in the coming weeks as we develop our plans.

John Holden was previously Director of Policy, Partnerships and Innovation, since the publication of these blogs he has left NHS England.

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  1. Jo Diaper says:

    It is encouraging to read that there is to be a lot more focus on the networks, including cpd training requirements and level of equipment required. One further thing to consider is how child appropriate care can be given in district hospitals outside of clinics. For example, 24 hour tapes. This often involves children sitting with oaps and staff with no ability or experience of dealing with children. Our experiences at our local hospital leave a lot to be desired. As an example, on one occasion, a member of staff objected to my son having a monitor after she became aware that he would be wearing it at school because it cost £3000! It turned into quite a battle to be honest and not something younger patients should have to go through if more reliance is to be placed on local care.