Congenital Heart Disease: the next steps

The year has started with a big push for us on two pieces of work with providers and commissioners. Together they provide assurance of what is being done across the country to meet the new standards for care.

Assurance relating to existing services – the new standards take effect in April, and NHS England has a responsibility to ensure compliance.

To do that, we have written to all hospitals involved in Congenital Heart Disease (CHD) care to ask that they assess themselves against key standards and provide evidence that they meet them. If the standards are not met, we are seeking assurance that appropriate safeguards are in place and that plans have been developed to meet standards as soon as possible.

As well as the main surgical centres, we have also written to every hospital where there is evidence of surgical or interventional practice and asked them either to ensure that the standards are met, or to make arrangements for this work to be transferred to an appropriate surgical centre.

We aim to complete the process in time for agreeing contracts for 2016/17 at the end of March.

Commissioning new service models – we have been working with hospitals since April 2015 on new service delivery models.

The panel which reviewed the proposals found them to fall significantly short of meeting the standards, which represents a real safety risk. So we are asking NHS England’s Specialised Services Commissioning Committee (SSCC) to advise on our future commissioning approach for CHD services. We will update you as soon as we have heard the outcome of their discussions.


The Programme Board has continued to meet, with its latest meeting on 13 January this year, taking the opportunity to review progress on the programme’s objectives:

Objective 1 – To commission specialised services

The report from the national panel was shared with the Programme Board, which now awaits advice from SSCC.

Objective 2 – To establish and deliver a programme of support for the changes

The Programme Board agreed that the Clinicians’ Group would devise a structured programme focussed on meeting the standards, to identify challenges and share best practice, to support centres’ development.

Objective 3 – To establish a system for monitoring and managing adherence to the standards

The Programme Board agreed work should start on developing and preparing for full peer review at a later date.

Objective 4 – To ensure the delivery of proposals for earlier diagnosis agreed by the NHS England Board

An update was received on the work of the Early Diagnosis Oversight Group, including: the Anomaly screening programme; New National data management system; Sonography workforce; and the Pulse oximetry pilot.

Objective 5 – To ensure the delivery of the proposals for better information agreed by the NHS England Board

There was an update on the development of the Quality Dashboard which should begin testing from April 2016. Proposals for commissioning a new survey of patient experience were agreed that will for the first time give us insight into the patient perspective on services.


One of our blog readers kindly provided some feedback to my last blog in which I wrote: ‘…some of the material now being produced is ‘commercially sensitive’ or ‘commissioner sensitive’ and therefore can’t be shared publicly…’

One reader, Sue, was concerned. She said: “The NHS is not a business it is a public service. I fail to see how this statement is relevant…One of the criticisms of the Safe and Sustainable review was the inconsistencies between the treatment of different centres…I truly hope that NHS England is going to treat every centre and patients from each part of the country fairly.”

Sue is right of course that the NHS is a public service, but it is still subject to a range of legal and regulatory requirements. This means that some information provided by organisations bidding to provide services won’t be in the public domain. But please be assured that while this places some limits on the information we are able to share, we remain committed to transparency. And we continue to work closely with the hospitals involved in providing these services and with representatives of patients and their families from across the country, as I hope I have made clear throughout this update.

Views sought on Clinical Reference Group working

NHS England is suggesting a number of changes to its Clinical Reference Groups (CRGs). This will be of interest to many readers of the blog because the CRG plays an important role in our work together.  If you want to find out more and join in the debate, the proposals are set out in detail and the consultation closes on 10 March 2016.

Image of Will Huxter

Will Huxter is Regional Director of Specialised Commissioning (London) at NHS England and currently chair of the NHS England Gender Task & Finish Group.

Prior to joining NHS England in June 2014, Will worked in a range of commissioning roles within the NHS, and for five years at an NHS Trust.

He has also spent eight years working in the voluntary sector.

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