NHS officials have been ordered to re-evaluate the streamlining of children’s heart surgery services after the decision to close three units, including in Leeds, was deemed to be flawed.

Plans to shut the units in Leeds, Leicester and west London were put on hold by Health Secretary Jeremy Hunt after an independent review suggested that the consultation process “left too many questions unanswered”.

The Safe and Sustainable Review’s proposals to shut paediatric cardiac surgery units in Leeds General Infirmary (LGI), Glenfield Hospital in Leicester and the Royal Brompton in west London “cannot go ahead in their current form”, Mr Hunt said.

The £6 million review into streamlining paediatric cardiac surgery in England has been heavily criticised and campaigners have fought ferociously against the closure of the units.

Two separate legal challenges were launched against its process, including the first-ever case of an NHS organisation taking legal action against another.

Mr Hunt said he asked NHS England to continue with the process of looking into the reorganisation of children’s heart surgery, saying that the streamlining of services must continue.

The Independent Reconfiguration Panel (IRP), the body tasked with reviewing the Safe and Sustainable Review’s final decision, concluded that “the decision was based on flawed analysis of incomplete proposals and their health impact, leaving too many questions about sustainability unanswered and to be dealt with as implementation risks”.

Speaking in the Commons, Mr Hunt said: “This is clearly a serious criticism of the Safe and Sustainable process. I therefore accept (IRP’s) recommendation that the proposals cannot go ahead in their current form and I’m suspending the review today.

“NHS England will also seek to withdraw its appeal against the judicial review successfully achieved by Save Our Surgery in Leeds.

“I know that many families have found the Safe and Sustainable Review to be a traumatic experience. People are rightly proud of the hospitals and the staff that have saved, or tried their best to save, the lives of their children.

“However, there is overwhelming consensus that we cannot stick with the model of care we have now. To do so would be a betrayal of the families who lost loved ones in Bristol who want nothing more than the NHS to learn the lessons from their personal tragedies.

“So it is right we continue with this process. But it is also essential that it is performed correctly so that any decisions, as difficult as they may ultimately be, carry the confidence of the public.”

Prime Minister David Cameron said: “I think we have to be frank with people that we can’t expect really technical surgery, like children’s heart operations, to be carried out at every hospital in the country.

“As the parent of a desperately ill child, wanting to get the best care for that child, you need to know that you’re getting something that is world-best. For really technical operations you can’t get that everywhere.

“Clearly the conclusion is that this process, which started in 2008, hasn’t been carried out properly so we need to make a restart.”

The original decision to close the three units was part of a general review of children’s heart services across England, based on the premise that there was a need to concentrate expertise in more specialist centres.

The IRP said “the case for change remains”. It made a series of recommendations about how officials should proceed with the process of streamlining services.

NHS England said it will “lead a rethink of plans” to improve children’s heart surgery.

The organisation’s medical director, Professor Sir Bruce Keogh, said: “We welcome the review and NHS England will now study its recommendations in full to learn from them.

“We will institute a new process that recognises the very strong case for redesigning services to meet the demands of the future whilst addressing the legitimate concerns in our local communities.”

Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, said: “The need for reconfiguration has never been more urgent.

“It is encouraging that NHS England has been tasked with devising a plan to take forward the review quickly. Decisions around complex issues such as reconfiguration will always involve some difficult judgment calls and hence be open to challenge, however robust the process.

“It’s important to identify and acknowledge where there have been shortfalls, but we cannot let the problems with this particular process stall further what is crucial for ensuring safe and sustainable health services for children.”

Anne Keatley-Clarke, chief executive of the Children’s Heart Federation, said: “Ever since the Bristol baby tragedy we’ve been campaigning to ensure that another crisis in the care of vulnerable children can never be allowed to happen again.

“As this review was clinician-led and the recommendations were agreed by their professional bodies and many parent groups, it has been really disappointing to see the implementation of the necessary improvements delayed.

“We want all heart children, wherever they live in England, to have access to an excellent service.”

 

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