The Most Reverend & Right Honourable
Dr. John Sentamu, Archbishop of York
The Office of the Archbishop of York
24 January 2013
Dear Dr Sentamu,
We were pleased to learn of your interest in the review of paediatric cardiac services and of your support of the families of children receiving treatment, but were concerned to read you criticisms of the Safe and Sustainable Review.
We feel that in our role as the UK’s leading children’s heart charity, which with our member organisations represents thousands of families caring for heart children across the UK, we should remind you that the review was a long-awaited clinician led review, which started with the development of care standards which will ensure the highest quality of care and is not part of a cost-cutting exercise as your remarks seem to suggest.
Those standards included the requirement for each surgical unit to have 4 surgeons conducting between 400 and 500 operations per year, thereby ensuring the highest quality care of children needing heart surgery with around the clock care.
CHF is supporting the implementation of these standards because we believe that they will ensure that surgeons operating on children will be based in well resourced centres of excellence and are able to provide round the clock cover. This will ensure that all children can receive necessary surgical treatment in a timely manner – and avoids the risk to children of surgeons carrying out surgery of which they have little experience (the occasional practice that was found to be so dangerous to the children in Bristol in the late 1990s).
As the number of cardiac operations on children remain fairly constant year on year, it was clear that some units would no longer offer surgery. However the ongoing cardiological care needed would be provided at all of the existing and possibly at additional units also.
It needs to be understood that half of all children with a heart condition do not require surgery and that most others will need just one operation. So surgery is only part of a heartchild’s treatment.
CHF supported the recommendations because we and many of our member groups believe that the change will also result in better services and that the development of the new congenital heart networks will ensure many will be seen closer to home.
We welcomed the decision of the Joint Committee of Primary Care Trusts on the 4th July 2012 and hoped that this would end the uncertainty as to which units will continue to provide children’s heart surgery, the delays to planned improvements in children’s heart services have caused a great deal of concern for parents and professionals.
Instead we have been disappointed to see an increase in uncertainty. Indeed the delays in implementing the planned improvements to children’s heart services across England are causing real problems for parents and medical professionals. We are seeing planning blight in services because uncertainty in the future of services has meant much needed staff are not being recruited, investment in services is not taking place as managers wait to be certain their unit will continue to provide surgery.
Although we understand and respect parents and clinicians loyalty to their local unit we are concerned by alarmist comments made by those fighting the changes, comments which could be described as misinformation, scaremongering and shroud-waving.
We welcome the debate that is being carried out, but feel that it is beholden on influential commentators to appraise themselves of the facts before making pronouncements. We feel that your comments have unfortunately reinforced a misconception that is developing amongst some parents; which is that units which are not designated for surgery will not continue to provide cardiology support and all the other heart services they currently provide. This is not the case. Whilst surgery may cease, other services are planned to continue at cardiology centres and through planned regional networks, more services should be provided even closer to home.
This review is designed to improve services and save children’s lives and we urge you to support it. We hope that you will work towards reconciling the various parties involved; urging all concerned with the care of heart children to work together during this difficult period to ensure that new standards of care can be implemented across the country and ensure that there are no further delays which are worrying as well as disruptive to families.