No evidence for heart targets

Operation stats not used

NHS bosses have been criticised for setting ‘arbitrary’ surgery targets which threaten the future of Leicester’s children’s heart unit.

The East Midlands Congenital Heart Centre (EMCHC) faces closure because NHS England say its surgeons are not carrying out enough operations to maintain and improve care and ensure quality and consistency.

A number of 125 procedures per consultant is the target. But at a public meeting, the first since NHSE said it would no longer commission services at the Glenfield unit, Mark Wightman the hospital trust’s director of communications said there was no scientific evidence to support the figure and NHSE should instead look at the unit’s outcomes, its zero mortality and its actual results.

Mr Wightman accused NHSE of changing the goalposts, saying: “We now note the standards we consulted upon changed at some point after the clinical engagement exercise from a commitment to achieve three surgeons and 375 operations from the introduction of the new standards in April 2016 to a retrospective three surgeons and 375 operations by April 2016 - in effect NHSE shortened the timescale for delivery by three years which they must have known would then automatically exclude Leicester and yet still took a paper to the NHS National Board which said ‘major reconfiguration of specialist services with the associated risk and upheaval can probably be avoided’.

“All that aside we would remind colleagues again that the evidence for 125 cases being the ‘magic number’ is in NHSE’s own words ‘arbitrary’. The people the NHSE tasked with researching this found that ‘while a relationship between volume and outcome exists, this is unlikely to be a simple, independent and directly causal relationship’. In other words no cut-off relating to surgical volume and better identified.”

His rebuttal came at a meeting of the Leicester City Council Health and Wellbeing Board during which Will Huxter, managerial lead for child heart disease review NHSE said scrapping paediatric heart surgery at Glenfield was about standards, not saving money.

However, the trust say clinical outcomes are some of the best across the country and feedback from patients’ families has a satisfaction rate of 99%.

Trust officials also say if the EMCHC closes it will mean the loss of 12 paediatric intensive care beds, more than half the total number in Leicester.

As well as this the pioneering paediatric extra corporeal membrane oxygenation (ECMO) service would also be lost.

The ECMO at Leicester provides 50% of the capacity for the whole country and is the only unit providing a national transport service. outcomes was