The number of hospitals in England permitted to perform children's heart surgery is set to be reduced from 13 to 10, following a long-running controversy. NHS England has published what it hopes will be the final decision, after previous reviews led to legal action from some NHS trusts.
Under the plans, three level 1 centres that perform surgery will lose their service: Central Manchester University Hospitals NHS Foundation Trust, University Hospitals of Leicester NHS Trust, and Royal Brompton and Harefield NHS Foundation Trust in London. Additionally, five level 2 specialist cardiac centres, which do not perform surgery, will be cut from nine to four. These include Blackpool Teaching Hospitals NHS Foundation Trust, University Hospital of South Manchester NHS Foundation Trust, Papworth Hospital NHS Foundation Trust, Nottingham University Hospitals NHS Trust, and Imperial College Healthcare NHS Trust.
All units were assessed against new standards and found to provide safe care, with death rates within acceptable limits. However, NHS England said some saw too few cases to maintain standards, as evidence suggests surgeons need a certain number of patients each year to remain competent. Officials hope centralising services will improve outcomes, with more patients surviving and children born with congenital heart defects living longer into adulthood.
Dr Jonathan Fielden, NHS England director of specialised commissioning, said: 'Patients, families and staff need to be assured of sustainable, high quality services now, and into the future. There has been a great deal of uncertainty over the future of congenital heart disease services over the past 15 years. We owe it to patients, families and staff to end that uncertainty.'
Some trusts have vowed to fight the decision. Leicester said it would not sit by while officials 'destroy our fabulous service', noting its results were among the best in the country and that closure would threaten other key children's services, including intensive care. Professor Sir Ian Kennedy, who chaired the public inquiry at Bristol Royal Infirmary, welcomed the move as 'good news for patients'.
