The Health and Social Care Board at a Public Meeting in Belfast on Thursday 25th April approved a preferred option document for the future commissioning of paediatric cardiac surgery and interventional cardiology for the population of Northern Ireland. This recommends a solution with surgery and interventional cardiology being carried out in Dublin. It also recommends major investment in paediatric cardiology in Belfast, including new MRI facilities.
The preferred option document will now be submitted to the Minister for Health, Social Services and Public Safety, Edwin Poots MLA, for a final decision.
Speaking after the Board meeting, the HSC Board Chief Executive John Compton said that the decision had emerged from detailed work to develop standards for the future commissioning of paediatric cardiac surgery and interventional cardiology for the population of Northern Ireland.
Mr Compton said: “The HSC Board is very sensitive to the fact that this decision will affect the families and children currently using the service. The Board has only one objective and that is to provide a safe, high quality and sustainable service into the future. The Board has and will continue to work closely with those who use the service to ensure that any changes are properly explained and where possible take account of family views.
“I would also like to acknowledge the dedication and personal commitment of all the clinicians, nurses and all other staff who, over many years, have and will continue to provide excellent cardiac care to children in Northern Ireland.”
In August 2012, the HSC Board, at the Health Minister’s request, established a Working Group to develop a framework for the future commissioning of services for children from Northern Ireland who require cardiac surgery or interventional cardiology procedures. Membership of the Working Group included clinicians, service providers, commissioners, parents of children with congenital cardiac disease and parent group representatives.
A comprehensive public consultation on a proposed framework for the future commissioning of services was undertaken between September and December 2012. This process included a series of public meetings and focus groups held across Northern Ireland. Taking account of the consultation responses and feedback from the public meetings and focus groups, the Working Group agreed a post consultation document which set out a revised commissioning framework in February 2013. This was approved by the HSC Board at its meeting in February 2013 and subsequently by the Minister in March 2013. The Working Group was then asked to assess and score each of the 8 options against the agreed criteria in the post consultation document with a view to providing a recommendation to the Minister on the proposed way forward.
Following assessment and scoring of each option, and careful consideration and detailed discussion, the majority of Working Group members concluded that the preferred option would be to commission paediatric cardiac surgery and interventional cardiology from Dublin. This option was considered to provide safe, high quality care in a centre that meets prevalent standards, while minimising the inconvenience and impact of travelling for patients and families. It was the view of the Working Group that this option would be able to provide robust 24/7 cover; ensure that emergency and urgent procedures can be undertaken within clinically indicated timescales; and deliver the required number of procedures.
With this option there would be no paediatric surgery or interventional cardiology in Belfast. However, it is proposed that the paediatric cardiology service in Northern Ireland, which saw 3,800 outpatients in 2011/12, would be enhanced and expanded. Under the preferred option clinical linkages and partnerships between Dublin and Belfast would be formalised as part of an all-island network.
It should be noted that two Working Group members from the Children’s Heartbeat Trust Charity did not agree with the preferred option. The Working Group was content to include a minority report submitted by these members in the preferred option document.
Mr Compton added:
“I would like to extend my sincere thanks to the Working Group and everyone who has taken part in this important process which has been inclusive, robust and thorough. It is essential that every child in Northern Ireland who requires specialist cardiac care has access to safe and high quality care that meets the very highest standards. I am confident that the work undertaken will help sustain access to excellent care into the future.”