Alison Poole, Senior Manager Special Projects, University Hospitals of Leicester (UHL) NHS Trust submits a briefing paper that provides the committee with an update on the Congenital Heart Disease (CHD) services in the East Midlands and progress of the national reviews on Paediatric Intensive Care (PICU) and Extra Corporeal Membrane Oxygenation (ECMO) services in England.
The report follows on from the decision of the NHS England National Board made on 30 November 2017 to continue to commission University Hospitals of Leicester NHS Trust to provide level 1 CHD services, conditional on achieving full compliance with the standards in line with their own plan to do so and demonstrating convincing progress along the way.
Dr Frances Bu’Lock, Honorary Associate Professor in Congenital and Paediatric Cardiology presented a briefing paper that provided the committee with an update on the Congenital Heart Disease (CHD) services in the East Midlands and progress of the national reviews on Paediatric Intensive Care (PICU) and Extra Corporeal Membrane Oxygenation (ECMO) services in England.
The Chair stated that the committee was very pleased that the NHS England National Board had agreed to continue to commission the UHL NHS Trust to provide Level 1 CHD services, and that a fair and achievable target had been set. She thanked members of the committee and officers for capturing the intricacies of discussions in such detail, and while many people had been involved in the campaign, she felt that the contribution of the committee could not be underestimated. Dr Bu’Lock also expressed her appreciation for the rigour with which the committee had challenged NHS England.
Dr Bu’Lock explained that many of the targets were similar to those in the other centres, with the main exception being that they had to move the paediatric part of the service to co-locate with the children’s services. The Chair stated that if the capital funds were available, the paediatric service would move into the Kensington building, but if capital was not made available, the service would locate in the Balmoral building and she questioned how long the service could wait for a decision regarding funding before opting for the Balmoral. Members heard that there was some flexibility in awaiting the decision. Dr Bu’Lock commented that that the NHS did not have the funding so this was dependent on the outcome of discussions with NHS Improvement and the funding for the Sustainability Transformation Plan.
Members heard that while no adult surgical cases were completed for three to four weeks because of winter pressures and the demand for respiratory beds; the Trust put in measures to prioritise paediatric cases where beds in the High Dependency Unit were sufficient as opposed to beds in Intensive Care. The overall target for surgical procedures was met but issues around winter pressures could impact on future targets.
The Chair stated that she and the Vice Chair had received a letter from Nottingham City Council seeking assurances that the committee would continue to monitor performance against targets set by NHS England. The Chair said that they would write to Nottingham to give them those assurances. Dr Bu’Lock expressed concerns that the University Hospitals of Nottingham were carrying out congenital cardiac intervention procedures on patients, although they were no longer supposed to be doing this. Concerns were expressed that this was placing patients at risk. It was also noted that this impacted on the numbers of patients undergoing surgical procedures in Leicester. Dr Bu’Lock added that it would be very helpful if the committee would write to Nottingham City Council to encourage them to ask the University Hospitals of Nottingham to refer all of their congenital heart work to the UHL. It was agreed that this would be included in the recommendations.
The Chair concluded the discussion and stated that it appeared that there were no further updates on PICU and ECMO services at the moment but asked for any relevant updates to be brought to the committee at the appropriate time.
1) that the committee agree to continue to monitor performance against the targets set by NHS England and an update be brought to the committee in one year’s time, particularly to include targets, issues around winter pressures and the numbers of referrals;
2) that a letter be sent to Nottingham City Council providing assurance about the monitoring of targets and to request that they encourage the University Hospitals of Nottingham to refer their congenital heart patients to UHL; and
3) that the minutes of this and future meetings of the committee where Congenital Heart Disease is discussed, to be shared with Nottingham City Council.