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The new Congenital Heart Disease review: 18th update
We have been asked whether investigations into the quality of care at local congenital heart units are linked to the work of our national review.The answer is that although they are separate from our review, we are receptive to any lessons from these reviews which can help us to commission the best possible service for all patients in England. One obvious way we can embed the lessons learned is by amending the service specification, on which we intend to consult soon, and which will be used for commissioning CHD services from April 2015 onwards.
Patients, families and their representatives
I was asked a question before the recent public and patient meeting (10 February 2014) about the cost of the new CHD review. I did not have the opportunity to answer this in the meeting, so I’ll do it here instead. The end of the financial year is still over a month away, but we estimate that the cost of the new review in 2013/14 will be around £350,000. We will publish a final figure when we have one.We have budgeted for significantly more expenditure in 2014/15, which reflects a number of additional factors including higher staffing levels, 12 weeks’ public consultation on the new standards, and ongoing work on the other five objectives of the review. Our current estimate is £850,000, but we will provide further information in due course.
Clinicians and their organisations
Thank you to everyone who has suggested possible references for the literature review being undertaken by The School of Health and Related Research (ScHARR). ScHARR have conducted an initial search of the literature as per their proposal outlined in Blog 17. From their search and suggested papers they have identified 22 references from 2009-2014 which have passed their first inclusion test and they plan to fully examine for potential inclusion in the review. This list is available here. Please review this list – if you can identify any papers that fall within their scope and date limits that have not been suggested and are not included in the list above, then please let us know by emailing the reference to firstname.lastname@example.org by Monday 3 March 2014.
ScHARR are in the process of drawing up a list of references for the 2003-2008 evidence. They will do this by examining the reference lists of the 22 references for 2009-2014, plus reference lists of other key papers, as well as using the Ewart review and citation searching any of its references. We will share the list with you when we have it.
NHS England and other partners
As the Board Task and Finish Group is not meeting this month (February 2014), I produced a note to update them on progress, which is available here.
The progress of the new CHD review was reported by BBC North East on Saturday 14 February 2014 – you can follow a link to the story here. The article refers to the fact that we intend to run a 12 week public consultation on CHD specifications from late spring/early summer 2014. We expect consultation to complete in autumn 2014, and this will help us to finalise the specifications that NHS England uses to commission services for congenital heart disease from April 2015 onwards.
As NHS England is doubtless already aware one of the inquests arising out of a death after heart surgery at Bristol Children’s Hospital concluded this last week, and a large portion of the criticism fell on the IT system in one of the outreach clinics. The care model proposed in the original review would have devolved a significant amount of responsibility down to local hospitals, (which may be good, bad or indifferent) and this was part of the “carrot” for downgradings. Indeed, iirc, units were marked down in the Kennedy assessments if they took too much of a top down approach to their networks. The downside of this, is that with an increased number of systems involved it introduces more opportunity to
“lose a nail”, somewhere along the line, as in this case. Is this something that NHS England is taking on board for the new review?