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The new Congenital Heart Disease review: 25th update

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

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From time to time we are challenged as to whether the review has a pre-determined outcome. Some think we have already decided that one or more units have to close, and that we know which ones. Others think that we have already decided that no units will close, come what may. The truth is that nothing is decided yet, but I do understand that in the absence of a simple clear cut decision, everyone will have a view. I recently exchanged correspondence with a national charity on this point and I enclose the exchange here so you can see how I have replied.

Another comment that we have heard recently is: this is all taking too long. I have some sympathy with this view and I would love to accelerate the work of the review, because “limbo” is damaging. But I also know that short cuts in the process will damage the credibility of our conclusions, and leave us wide open to challenge in the courts and elsewhere. We have to follow the process that NHS England has prescribed for the development of service specifications, even where this seems unusually difficult given the wide range and sensitive nature of our review. And we are trying, I hope successfully, to be as open and inclusive as possible. With this in mind I wanted to draw your attention to the papers for our Programme Board on 10 June 2014 (see link below). Item 5 on the agenda (“Timeline update”) explains that we will not now begin consultation at the end of July 2014 as we had hoped. Instead we are now targeting mid-September. We think this is the earliest possible date we could launch consultation, and even to achieve this will be very challenging. In part this is due to amount of work we need to do to prepare the consultation materials. In part it is due to the challenge of satisfying the governance controls, especially providing financial assurance (i.e. that we are not creating an unaffordable and therefore unrealistic specification for the service). I know this delay will be frustrating and disappointing for some of you, which is why I wanted you to hear it direct from me.

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All three of our engagement and advisory groups (Clinicians, Provider Leaders and Patients & Public) told us they would find it helpful to have a joint meeting between the groups, prior to consultation on standards. We have struggled to find a convenient date, so I am pleased to confirm that the date for this joint meeting is now set for Friday 25 July 2014 in Central London.

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You will remember that our “call for evidence” asked for suggestions as to published literature which could be reviewed by the ScHARR team (from the University of Sheffield). In April 2014 we published their draft report, which detailed their methods and findings from a review of the relevant literature. ScHARR were looking to see if there was published evidence regarding any link between patient outcomes and the way services are organised. Since April, their draft report has been quality assured and peer reviewed. The final report is now complete and was published on 4 June 2014 on the NIHR website. You can view the final report here. The implications of their report will be considered by the Clinical Advisory Panel next week.

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Patients, families and their representatives

We held a workshop on Monday 12 May 2014 with members of our Patient & Public Group to discuss how best to achieve an effective consultation on standards. A summary of the key points from the workshop is available here.

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We have done our best to meet at times and in locations convenient to the majority of charities and patient support groups, but for some the timing has meant that it has been difficult to send any representatives on a regular basis. Michael Wilson and Claire McDonald therefore recently met with representatives of Families of Ocean Ward (linked to the CHD service in Southampton) to provide a briefing that summarised the material from the most recent Patient and Public Group meetings.

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The next meeting of our Patient & Public Group (chaired by Professor Peter Weissberg) is scheduled for Friday 13 June 2014 in central London.

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A final reminder – on 17 June 2014, NHS England’s Patients & Information Directorate are holding their second “Open House” day, between 10am and 3:30pm at four locations around the country. Open House days are a fantastic opportunity for patients and the public to influence the work of NHS England at national and regional level, and will provide you with the opportunity to hear about and influence national programmes such as care.data.   For more information, and to register, click on the links below:

  • York
  • London
  • Basingstoke
  • Leicester

Clinicians and their organisations

Professor Deirdre Kelly, Chair of the review’s Clinicians’ Group, along with members of the review team, has concluded her planned programme of visits to the specialist centres around the UK – most recently to UCLH, Great Ormond Street and the Heart Hospital (28 May 2014), Leicester (30 May 2014), and Cardiff (4 June 2014). At the recent clinician group meeting Professor Kelly received additional invitations so we are now scheduling these additional visits. Once all the Trust visits have taken place the review team will pull together a report summarising the visits.

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A meeting of our Clinicians’ Group (chaired by Professor Deirdre Kelly) took place on 2 June 2014 in central London. A copy of the agenda is available here, a copy of the slides used is available here and a note of the meeting will be available shortly.

NHS England and other partners

NHS England’s Board held its regular meeting in public on Thursday 15 May 2014 in London. One of the items considered was the update from new CHD review’s “Task & Finish Group”. A copy of the relevant Board paper is available here. A video recording of the discussion is now available on the NHS England website here. (See Item 9).

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Our Programme Board meets on Tuesday 10 June 2014, and the agenda and papers for the meetings are available here.

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Although separate from the new CHD review, you may wish to be aware that on 30 May 2014, NHS England published the terms of reference for an independent review into children’s cardiac services in Bristol.  This review will be led by Eleanor Grey QC, an independent barrister and former Counsel to the Bristol Royal Infirmary public inquiry, and Sir Ian Kennedy, the former chairman of the Bristol public inquiry, who will act as consultant advisor. The Review will be independent and its terms of reference have been drawn up following conversations with the families affected.  The review will establish an office in Bristol and seek to ensure all interested parties have an opportunity to make a contribution.  The review team will issue a public call for evidence and make further announcements about how to get in touch as soon as possible. You can read the Terms of Reference here.

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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