Tuesday, 5 April 2011

More on Safe and Sustainable - proposed changes to children's heart surgery service in the UK

Spent this morning at a Health Impact Assessment stakeholder forum where we discussed the impacts, mitigations and opportunities of the proposed changes.  As many people as possible need to provide their comments using the response form before July 1st, this is your opportunity to feed into the process.

Before you complete the form, you might find it helpful to at least take a look at "Safe and Sustainable: A New Vision for Children's Congenital Heart Services in England - Consultation Document" to increase your understanding of what the process is trying to achieve and how they arrived at the four options that are under consideration.  Although you may have read media reports that suggest this a cost cutting exercise, it's important that you understand that 
professional associations and national parent groups, who take a global
view of these issues, have repeatedly called for a review of children’s heart surgery services.
Although this is a direct quote from the consultation document, I include it here because I know from personal involvement that this statement is true.  The aim of this whole process is ensure that this is a national service, with national standards that ensure that all children get the very best care wherever that is provided.  Whilst the majority of families are already happy with the care their child is receiving, realistically most have no experience of another unit with which to compare, but national support groups are ideally placed to see a more national picture and have been heavily involved in seeking these changes.
Parents are naturally concerned about how these changes will affect them personally, but in order to make the best decisions, it is vital that everyone looks at the proposals impartially so that the focus is on the most important issue, that of giving children the very best chance in life.  When thinking about these changes we also need to understand that they are not recommending closure of any units, the proposal is only to reduce the number that actually undertake surgical procedures, which would mean that families will only potentially have further to travel when a child is having surgery and for nearly 98% that will be only once or maybe twice in their life.

We need to ensure that during these times, families are given better support to overcome the difficulties that may be compounded by being further from home but whilst recognising these and other issues, we cannot lose sight of the evidence that supports the need for change.  Evidence that shows a relationship between the number of procedures and surgeon undertakes each year and the outcomes for the children involved, not just looking at mortality but also morbidity.

It's also worth remembering that whilst this is a national process, it will not be the first time that a heart unit has stopped carrying out surgical procedures yet remained as a cardiac centre.  During my 20 years involvement I have seen several similar changes - in Scotland, Royal Hospital for Sick Children in Edinburgh sends patients to Yorkhill in Glasgow for surgery, Manchester Children's Hospital uses Alder Hey Children's Hospital in Liverpool, the University Hospital of Wales in Cariff sends patients to Bristol Children's Hospital and when the Royal Brompton and Harefield Hospitals combined, surgery stopped at Harefield.

So take a look at the consultation document, at the very least read section 2 and then make sure that you complete the response form online or request a hard copy and check out details of the consultation events for one in your area where you will have the opportunity to hear the proposals in more detail and discuss your personal concerns.