Legal battle 'could delay changes to children's heart surgery services'
A BRISTOL hospital director says a legal challenge to a national reorganisation of children's heart surgery could delay changes needed to improve the service.
A High Court judge ruled yesterday that there were flaws in the review of paediatric cardiac surgery, which had led to the Leeds General Infirmary's surgical service being earmarked for closure.
Campaigners fighting the Leeds service's closure launched a legal bid against the Joint Committee of Primary Care Trusts' Safe and Sustainable review because they believed the scoring system used to come to the decision was unfair.
The centralisation of paediatric surgery at specialist centres was proposed in response to the Bristol heart scandal, where more babies and children than expected died following operations in the city in the 80s and 90s, when surgery continued despite clinicians raising concerns.
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Bristol Children's Hospital, which was purpose-built in response to the recommendations from the independent report into the scandal published in 2001, turned around its surgical results following the scandal and was named as one of the designated specialist centres in July.
A hearing in the High Court later this month will go into more detail about what the judge's ruling means for the whole reorganisation and the designation of hospitals, including Bristol, as surgical centres.
Deborah Lee, the deputy chief executive and director of strategic development at University Hospitals Bristol NHS Foundation Trust , which runs the children's hospital, said: "I feel really disappointed that we are in this place.
"The need to change comes off the back of the learning from Bristol. Anything that means a delay to bringing benefits to children and their families really concerns me."
Ms Lee said she understood the concern of the families who did not want to see their hospital stop providing the service but said the review was "really thorough".
"I feel a sense of disappointment and frustration that we might find ourselves in a period of paralysis and delay," she said.
Work currently being carried out ahead of the transfer was in its planning phase and would not be affected by the judge's decision, said Ms Lee, adding that the trust would forge ahead with its plans.
She said: "Seventy-seven thousand people responded to this consultation and most of them thought this was the right thing to do. The issue with the case is that no-one wanted it to affect their backyard. The case has been won on a very narrow technical point."
The Children's Heart Federation echoed Ms Lee's comments.
In a statement, the charity said: "We are disappointed that this decision will result in further delays to the establishment of the new children's heart care network, adding to the considerable anxiety that some families of children with a heart problem have been living under for many months now. Uncertainty about the final configuration of surgical and cardiology centres is now increasing the variation in quality of services across the network, as it prevents necessary investment and destabilises staff teams – prompting some staff to move out of posts at centres whose future is uncertain.
"Lack of staffing leads to increasing waiting times for vital operations – which is potentially damaging to the frail health of some of the country's most vulnerable children."
The next hearing will be at the High Court on March 27 when the judge will decide whether to overturn the JCPCT's decision, effectively forcing them to start the process again.
In response to the ruling the chairman of the JCPT, Sir Neil McKay, said: "I am very disappointed with the court's decision. The pressing need to reform children's heart services is long overdue and experts have cautioned that further delay in achieving the necessary change would be a major setback in improving outcomes for children with heart disease.
"The judgment focuses on a single matter of process, but the case for the reconfiguration of children's heart surgical services remains strong. There is a rare consensus on the need for change right across the board – NHS staff, medical royal colleges, professional associations and national charities all support the case for fewer larger surgical centres, new national quality standards and stronger networks of care.
He said the reorganisation would continue and representations would be made to the court that quashing the original decision would be unfair and unnecessary.