Don’t scapegoat Oxford Heart Unit, urges charity

Children’s Heart Federation welcomes the continued suspension of the paediatric cardiac surgical service at the John Radcliffe Hospital until the outcome of the current Safe and Sustainable Review is known, and urges clinicians and health service planners to apply learning from Oxford across the national heart surgery service and to implement the agreed service standards, particularly those relating to the number of paediatric surgeons employed.

Commenting on the Oxford Inquiry, CHF’s Chief Executive Anne Keatley-Clarke declares,

“It’s easy to breathe a sigh of relief and act as though the problem has gone away when a dangerous incident has been dealt with, but Oxford raises concerns about the whole children’s heart care system that can only be resolved by introducing rigorous standards across the network. It would be wrong just to scapegoat Oxford.”

The charity is particularly concerned about the abuse of parents’ trust demonstrated in Oxford. Mrs Lo, the mother of one baby that died, summed up the problem when she said,

“A mother wants the best for her child and I trusted my baby to the hospital. What else could I do? I believed Nathalie was in good hands.”

Just a month ago, Professor Westaby was quoted as saying,

“It just would not be acceptable to stop doing this sort of surgery in a big university centre like Oxford.“

Ms Keatley-Clarke observes,

“It appears that managers and clinicians in Oxford put empire-building ahead of the well-being of critically ill children and their very vulnerable parents. Ego and trust can make a lethal cocktail.”

The abuse of trust is even more serious when a clinician talks to parents about the risk of a procedure using national average statistics rather than the results from their own service; this is what surgeon James Wisheart did in Bristol in the 1980s and, the charity understands, was the approach taken by the team in Oxford.

Four years ago, former consultant surgeon Tony Giddings asked,

“Do we need to have a second Bristol before we can actually make the cultural changes that are needed? We have continued to have avoidable deaths in surgery because the lessons that were so clearly set out in Sir Ian Kennedy’s report [into the Bristol Babies Scandal] have not been acted upon.”

The service standards developed as part of the ongoing NHS Safe and Sustainable Children’s Heart Surgery Services programme offer hope for the future, but only if politicians and clinicians put patient safety above popularity and self-interest to make the radical changes needed at national level and the cultural changes needed within teams.

 Ms Keatley-Clarke, who sits on the Steering Group of the Safe and Sustainable programme, reflects,

“Behind closed doors, clinicians and managers speak up about the deficiencies in a sevice where there are only one or two surgeons, but in order not to undermine parents’ confidence, they are reluctant to speak publicly. Hopefully, by putting in place stronger protocols for sharing information and examining practice, which make transparency part of our medical culture, parents’ trust will be well-founded and Oxford will be the tipping point that saves us from another Bristol.”

Ends

 

Notes for editors:

  1. The Children`s Heart Federation (CHF) is the leading UK charity working for families of children with heart conditions. CHF is an umbrella body with 22 member organisations that support children and young people with heart defects from birth or acquired in childhood and their families in the UK and Ireland. CHF provides information and support through its freephone helpline 0808 808 5000, open Monday to Friday and its websitewww.chfed.org.uk.
  2. Approximately 5000 babies in the UK are born with a heart condition each year, with a further 1000 developing a serious heart problem after birth. Around 3600 operations are performed by 31 paediatric cardiac surgeons within 11 centres in England each year.
  3. The NHS is currently reviewing services related to children’s heart surgery across England. This reconfiguration programme, known as Safe and Sustainable Children’s Heart Surgery in England,  is expected to lead to fewer, larger centres that provide surgery, after the publication of recommendations in autumn this year (see: http://www.specialisedservices.nhs.uk/safeandsustainable).