E05. Congenital Heart Services

Scope and service

Congenital heart disease is sometimes diagnosed in the womb, but often it is not identified until after birth or may even remain undetected until adulthood. Thanks to medical advancements over the last few decades, most people born with congenital heart disease now survive into adulthood, so there is a growing population of both children and adults in this country living with the condition. Major heart operations are most commonly carried out during childhood, but individuals with inherited heart conditions need networked and co-ordinated care which also covers the non surgical elements of their care, including contributing to the management of routine care for other childhood illnesses or conditions.

Chair and membership

A voluntary Chair is appointed for a three-year term. Please see the Clinical Guide for CRGs for further information. Clinical members are drawn from the 12 Senate areas in England and are voluntary appointments. Up to four patient and carer members and up to four professional/training organisations are eligible to join the CRG membership. The accountable commissioner holds the managerial accountability for the work of the CRG; collaborating commissioners hold an interest in the work of the CRG.

Chair Trevor Richens

Trevor Richens  is the lead for congenital cardiac catheter intervention, and a specialist in all forms of congenital catheter intervention from birth to old age.  Between 2003 and 2012, Dr Richens was a consultant in congenital heart disease and catheter intervention in Glasgow. He was also clinical link for the service, and paediatric cardiology training programme director for Scotland. Dr Richens Qualified at London University, 1990. Adult cardiology, London, 1996. Paediatric cardiology, Glasgow, 2000. Paediatric intensive care, Glasgow and Melbourne, 2000 to 2002. Dr Richens is The National workforce lead for the specialty advisory committee for paediatric cardiology and Vice-chair of the congenital cardiology clinical reference group.

National Clinical Director Co Chair Trevor Richens
N1 North East John O’Sullivan
N2 Greater Manchester, Lancashire and S Cumbria Andreas Hoschtitzky
N3 Cheshire and Mersey Ram Dhannapuneni
N4 Yorkshire and Humber Kate English
M1 West Midlands David Barron
M2 East Midlands Giles Peek
M3 East of England Clive Lewis
L1 London NW Duncan Macrae
L2 London NE Martin Elliot
L3 London S Gurleen Sharland
S1 South West Mark Turner
S2 Wessex Trevor Richens
S3 Thames Valley Satish Adwani
S4 South East Coast David Hildick-Smith

Patient and Carer Member

Vacant Post
Michael Cumper
Suzanne Hutchinson
Penny Green
Lois Brown
Hazel Greig-Midlane
Jonathan Arnold
Anne Keatley-Clarke

Professional Organisation

Association of Paediatric Anaesthetists of great Britain and Ireland Andrew Wolf
Royal Colleges of Nursing Gill Harte
Professional Organisation Name
Professional Organisation Name
Accountable Commissioner Julia Grace Leicester
Collaborating Commissioner Name Base
Pharmacy Lead Name Base
Public Health Lead Name Base
British Congenital Cardiac Association Andy Tometzki
British Cardiovascular Society Rob Henderson
Royal College of Nursing Gill Harte
Affiliate Organisation Name


A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 specialised services Area Teams to contract services on an annual basis.


The service specifications are important in clearly defining what NHS England expects to be in place for providers to offer evidence-based, safe and effective services. They have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards. Core standards are those that any reasonable provider of safe and effective services should be able to demonstrate, with developmental standards being those that really stretch services over time to provide excellence in the field.

The following service specifications have been prepared by the CRG:

Policy statements

A policy statement is a brief document that defines the current commissioning position to support service contracting. They are interim documents for use whilst a full commissioning policy is being developed or until a formal NICE Technology Appraisal Guideline has been published.


A commissioning policy is a document that defines access to a particular service for a cohort of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into a commissioning policy, as appropriate. These are important documents that are developed to define national consistency.

Quality measures

Quality measures aim to find the most appropriate and deliverable measures that can be used nationally to help organisations improve the quality of care in their services. These are prioritised to form a ‘dashboard’

Documents will be published online shortly

Innovation portfolio

The innovation portfolio is an opportunity to collate information on innovative approaches that may have been developed in one or more areas, and to consider whether these might be rolled out more consistently in the future. An innovation might, for example, become a core requirement of all providers, enshrined in the core national service specification.

Tell us about a new innovation which is already developed and available to the NHS that you would like us to know about. You can create a personal account or log in if you have registered previously and already have a personal account to use the CIMIT CoLab® specialised services web platform.


Commissioning for Quality and Innovation (CQUIN) is a framework that was first established as part of the 2009/10 NHS Operating Framework as an incentive scheme which forms part of the contract between a commissioner and a provider. CQUIN schemes link successful delivery of specific outcomes and actions with the release of an additional payment to the provider, which for 2013/14 is a payment of an amount up to 2.5% of contract value.

A CQUIN scheme is made up of a number of separate indicators (“CQUINs”) which address a range of clinical areas and issues. The purpose of a CQUIN scheme is to drive quality improvements across a range of areas. In 2013/14 there are no national CQUIN schemes for Congenital Heart services. CQUINs, once developed, for the 2014/15 contracting round will be published here in 2014/15.


Spending on the NHS will increase each year between 2011 and 2015. However, demand for health services is rising, and what is expected of the NHS changes as society changes. This means that the NHS will need to make up to £20 billion worth of efficiency savings by 2015, so that there are more funds available for treating patients and to allow the NHS to respond to changing demands and new technologies.

Productivity is one of the work streams to deliver those efficiency savings. Productivity is about the redesign and streamlining of healthcare services by examining the way the NHS commissions, manages, works and delivers healthcare services to reduce inefficiencies and maximise efficiencies; ensuring value for money; and reducing unnecessary poor design in its processes and delivery of care that are not cost effective, and have little impact on improved outcomes or improved quality of care for patients.

CRGs have a key role in providing advice about potential opportunities to improve productivity and efficiency, for example by removing any inefficiencies in care pathways or by identifying opportunities where a national procurement of drugs or devices might reduce costs.


Other important publications that relate to this CRG include:

Documents will be published online shortly