What is happening?
In February, NHS England published its proposals to implement standards for CHD services for children and adults in England.
This is the latest in a long journey, which stretches back to a public inquiry into the Bristol Royal Infirmary in 2001, and was followed by the ‘Safe and Sustainable’ review in 2008.
Why is NHS England doing this?
NHS England wants to make sure that hospitals have the right staffing levels and mix, with training and mentoring, to enable them to deliver the highest services of care.
The new standards were published in July 2016. They set out the need for cardiac surgeons to undertake at least 125 cases per year (3 per week) and require that there should be a minimum of three surgeons in the team to cover the workload 24 hours a day, rising to four surgeons by 2021. The standards also specify that specialist children’s cardiac services must only be delivered where there are a wider range of other paediatric specialities available in the same hospital.
In devising the standards, NHS England consulted with clinical advisors on the Clinical Reference Group and Clinical Advisory Panel.
How are services provided?
Services are based around a three-tiered model. Specialist surgical centres (level 1) deliver surgery and interventional cardiology. Specialist cardiology centres (level 2) focus on diagnosis, apples ongoing care and management. Level 3 services are provided in local hospitals by general paediatricians/cardiologists and provide initial diagnosis and ongoing monitoring. Services are commissioned by local Clinical Commissioning Groups (CRGs).
What does implementation of the standards mean for my hospital?
The proposals mean that the Royal Brompton, University Hospital Leicester, and Central Manchester University Hospitals are expected to cease providing surgery and interventional cardiology (level 1 services), while Blackpool, Imperial College, Nottingham, Papworth, and University Hospital of South Manchester are expected to cease providing specialist medical services (level 2).
Inevitably, this means that some families will have to travel for level 1 and level 2 services. However, NHS England considers that implementation of the standards means that children will receive surgery in the best possible environment to achieve a good outcome.
What happens next?
The consultation runs until 17th July (it has been extended given the election). Although no public events can happen during the pre-election period, NHS England has more planned before mid-July.
To find out about where the events will be, visit www.engage.england.nhs.uk/consultation/chd/
You can also see recordings of the events in Leicester www.youtube.com/watch?v=AcidnxC6Jek
And London www.youtube.com/watch?v=VI8FBU-b1Q0
By visiting www.engage.england.nhs.uk/consultation/chd/ you can provide a response to the consultation.