Review of Children's Cardiac Surgery Services

[saveourheartcentre]

I'm a mum of a child with a life threatening heart condition & we currently receive care at the Southampton Children's cardiac Centre. A current review proposes to reduce the number of centres doing surgery from 11 to just 6 or 7. The proposed configuration options have been announced by the JCPCT (Joint Committee of Primary Care Trusts, there are 4 possible options to go out to public consultation & my centre in Southampton is only named in 1 of the options! This is a complete & utter scandal as Southampton came 2nd in the overall ratings of the 11 centres! Why isn't Southampton in all four options? Should we be keeping the best centres & working on raising the quality in any of the other centres they need to keep just because of their location? Bristol's centre is in all 4 options but they came 6th! These review proposals are not offering us parents a quality option it is more about the location of the centre! I know you will have a large membership of mum's from in & around London & they too will be affected, the Brompton children's cardiac unit is going to be merged in to the other 2 remaining centres at Great Ormond Street & The Evelina.

We want the best quality care for our children not an option that focuses on geography! If Southampton isn't designated a Surgical Centre I would have to take my son to a centre that didn't score as well so how can that be improving the service for us???

[Rowerc5]

I totally agree, my son also is treated at Southampton and I think its appalling that a centre that has been ranked 2nd BEST in the COUNTRY faces closure due it location. Especially when we have been reassured by the review panel since the start in 2009 that QUALITY was the priority of the panel. How can they say they are doing this to improve care across the country but then take away a centre which is already achieving the model of the review as they want it.

Please help us to get our concerns raised. As WHY should we even consider having our children treated at a centre whereby they were ranked lower than southampton.

The CHF keep saying that parents will travel for the best care for their child, so why should it be that location has been picked over QUALITY.

[Rowerc5]

2ND BEST UNIT IN THE COUNTRY!!!

[ben5]

ds2 had heart treatment on ocean ward. they are wonderfulpeople there and not only did they look after ds2 they looked after us as a family unit. southampton was our closest heart place and we lived in plymouth at the time.
we now live in australia but if we can help let us know

[saveourheartcentre]

I'm sure most people would think that Great Ormond Street is the best Hospital for Children as it has a very successful Charity & Fundraising campaign, however to put in perspective some rationale behind the reasons to ensure Southampton remains a surgical centre it is important that people know Great Ormond Street were 4th in the same review of Children's Cardiac Surgery Services.
QUALITY, QUALITY, QUALITY
NOT
LOCATION, LOCATION, LOCATION!

[Rowerc5]

If Southampton was to close, we will have our surgical team move to another centre, but Southampton achieved the 2nd BEST unit in the country not only because of the Surgery but the infrastructure that is in place to support the surgery. This means PICU, Management, Family Support etc etc.

The WHOLE service was rated 2ND BEST IN THE COUNTRY. Other hospitals do not have the same and infrastructure hence why they didn't rate highly in the review.

And the WHOLE service WILL NOT move to another centre, only the surgical team!!

Its this we face losing and we will fight to keep it as it will affect a number of areas of the hospital.

If the infrastructure isn't right in a hospital, moving the surgeons WILL NOT make it a centre of excellence.

SOUTHAMPTON IS ALREADY A CENTRE OF EXCELLENCE FOR CHILDREN WITH CARDIAC PROBLEMS.

[REXD]

I agree. As a parent of a son with ongoing surgical needs I'm not opposed to anything that gives my son better care and was initially for the review. Now looking at the various options I'm not so sure and really don't think these people have thought this through at all.

I've read the expert panel reports on all the units and there are some good things but Brompton and Southampton are in the top 4 and both favourites for closure. That doesn't make sense. Worryingly the report identifies a few units where the experts had serious concerns about the ability of the icu to expand and meet the new standards and some are in several of the options. I honestly don't understand how those could be put forward as feasible options if a panel of experts have serious misgivings about them being able to actually perform when the time comes.

My head is just going round and round with it all and I think I'm going to be more worried about my child's safety after the review than I am now based on what I've read.

[flowerpowermum]

as my local GP said, why dismantle a successful and fully functioning cardiac unit, only to replicate it 70
miles west?

The principles behind the review are hard to argue with. To deliver quality care by skilled professionals, with the appropriate expertise and facilities.

However, if parents are willing to travel to receive such a service, then surely whether you go north or south should make no difference.

The arguement here is one against common sense!

[saveourheartcentre]

I completely agree with your comments.

If the point the Children's Heart Federation keep making is that "Parents will travel to get the best treatment" then it shouldn't matter where the best units are situated as no-one would ever choose to take their child to centre that is not of the same quality as the one they currently attend & that is basically what we are expected to do if the surgery is no longer performed in Southampton.

The NCAT report refers to centres only being as good as the team that works in it & therefore the de-stabilisation of a world class centre with outstanding records of achievement will be to the detriment of all our children for a number of years to come as the larger "Surgical Centres" build up the teams & working relationships.

I've never been opposed to the priciples of the review to ensure we have a "safe & Sustainable" service for our children but I do strongly disagree with dismantling top performing centres just to build an empire that fits the geographical requirements!

[LBBShoes]

My DS3 had a coarctation repair at Southampton in April 10 and I have to say that it was the most wonderful, caring, efficient, clean environment. If I had had to travel further afield I don't know how I would have cope (we are from Plymouth). If it ain't broke (which is a rarity with the current NHS) then why fix it? Surely this is just a handful of people feeling the need to justify their salaries! Absolute nonsense to move something that is working so well as it is!

PS Love and best wishes to you all who have been through Ocean Ward - esp if we met last year! Cece is doing really well.x

[rrl1]

This review has been a long time coming as it was started after the Bristol disaster (and they are in all 4 options!). In theory it sounds good. The more procedures a surgeon does the better he/she will be at it, and the better the child will do. However I have some major concerns over this review.

1. No risk assessment has been done to look at services once changes have been made. By this I mean no consideration has been given to how remaining units will be able to cope with huge increases in work load overnight. As a nurse I will not be moving if my unit closes. I can't. I have a family and a husband who works. My contract is with the trust and they can't sack me, so I guess I'll just have to work somewhere else in the hospital. Having spoken to colleagues, only 2 junior nurses would be prepared to move. Nurses with these specific qualifications and experience are difficult to recruit and this tends to be a problem for all trusts. To find an additional 30 or 40 nurses overnight will be impossible, but has been given no consideration.
   
2. There is no evidence to show that the 400 cases per year specified in the standards set is the optimal number that a surgeon needs to do in order to minimise mortality/morbidity rates. The only research I am aware of shows that units doing less than 125 cases per year have higher mortality rates. Furthermore they haven't even benchmarked against the rest of the world! There is evidence however to show that units that are too large are dysfunctional and will split themselves up to cope (thus defeating the object!). With some of the options this would happen.
   
3. Some errors were made with the information the commission took down when visiting the units and this information has not been amended, thus the decisions are being based on incorrect data! One of many examples is that one unit was said to not provide 24 hour PICU cover, when in fact it does. This impacts on the viability. I apologies for my rant, however I truly believe there are some major faults with this review process and my hope is that no child suffers due to the process.

[rrl1]

I would like to make another quick rant! Are you aware that one of the questionnaires had to be removed because of the type of questions that were put in? As a mother I would travel to the ends of the earth for my children, and that would be my response to the question. However the question I wasn't asked was "would I prefer not to have to?"
I would love to know how much money has been spent so far on this review, and whether instead of some contentious results we could have all been living near a first class centre?

[CalderJon]

If anyone is interested, Calders Confessions are running a show covering this subject this Sunday 24 April 2011 on vectisradio.com (online only) - if anyone wants to put their views across, please feel free to call the studio on 01983 527444 or email [email protected] or leave a voicemail on 01983 898987

Previous interviews on this subject: //www.calderjon.com