A report on Northern Ireland services for children with heart disease was published today by the Health and Social Care Board (HSCB). The report followed a review of children’s heart services at the Belfast Health and Social Care Trust undertaken by an independent expert Review Panel which was announced in March of this year. The review included an onsite visit to the Belfast Trust during which the Panel assessed services and met staff and parent group representatives.
The aim of the review, which examined the safety and sustainability of the service, was to ensure that children with serious heart conditions continue to receive high quality, safe and sustainable care.
Commenting on the Review, HSCB Chief Executive John Compton said:
“The review found that children in Northern Ireland with congenital heart disease are well served by a dedicated and experienced paediatric cardiac team in Belfast who provide a wide range of cardiology services. The review highlights that there are many excellent features in the current service that present opportunities for the development in the future of a model children’s cardiology centre.
“The Review Panel did not identify any immediate safety concerns presented by current arrangements.
“However, given the small population in Northern Ireland and the relatively low numbers of children needing such specialised care, the Review Panel concluded that it was not sustainable for surgical services to be provided in Belfast in the future.”
The assessment of current services by the Review Panel is consistent with the expert recommendations accepted by the NHS in England that such surgery is performed in large designated centres that maximise clinical safety and effectiveness. Across England the number of specialist centres for children’s heart surgery is planned to reduce over the next few years. Wales has no such centre, with its population being served mainly by hospitals in Bristol and Liverpool. Scotland has one centre, in Glasgow.
Health Minister Edwin Poots has asked the HSCB to establish a Working Group to develop proposed criteria to provide a clear objective basis for future decisions on paediatric cardiac surgery and related services, and to draw up a commissioning specification for the delivery of this service for Northern Ireland. This will be considered by the Minister as a basis for public consultation in the autumn. Parents groups and clinicians will be fully involved in the work of the Group.
Mr Compton added: “A relatively small number of children have congenital heart disease and of those who do, around 140 from NI require surgery each year.
“Children’s heart surgery is one of the most complex undertaken by the health service, and there is an absolute need to ensure that children are able to have access to the very best services. We know that some aspects of care can only be sustained in larger, specialist centres of excellence.
“In line with the Minister’s requirements, the HSCB will now set up a Working Group, consisting of parent groups and clinicians to ensure that this very important issue is progressed in the most appropriate way.”
A copy of the report is available on the HSCB website
Professor Sir Ian Kennedy (Chair), Chairman of the Public Inquiry into children’s heart surgical services at the Bristol Royal Infirmary, and Former Chair of the Healthcare Commission.
Mr James Monro, Consultant Cardiac Surgeon, Southampton General Hospital (retired).
Dr Michael Godman, Consultant Paediatric Cardiologist, Royal Hospital for Sick Children Edinburgh (retired).
Maria von Hildebrand, lay representative.
Dr Neil Morton, Consultant in Paediatric Anaesthesia and Pain Management, Royal Hospital for Sick Children in Glasgow.
Sally Ramsay, independent adviser in children’s nursing.
Julia Stallibrass MBE, former Deputy Director of National Specialised Commissioning.
Dr Roy Sievers, Consultant Paediatrician with Expertise in Cardiology, Portsmouth Hospitals NHS Trust.
Each year approximately 140 children under the age of 16 years in Northern Ireland require surgery for congenital heart conditions. Currently, most patients have their surgery at the Belfast Health and Social Care Trust while a number of children are transferred to other surgical centres outside of Northern Ireland.
The review considered the current services provided in Belfast, taking account of the Safe and Sustainable quality standards, which have been accepted by the NHS in England and Wales. Amongst the criteria are the requirements that: