Centralise rare paediatric heart condition surgery to maximum two expert-validated units

The Index has not yet recorded a verbatim government response to this recommendation.

As the Thirlwall Inquiry has noted, the subsequent Paediatric and Congenital Cardiac Services Review Group report stated that performing such procedures in a maximum of two units would be unduly restrictive.

In addition, the outcome of the Safe and Sustainable Review in 2012, which included recommendations on reconfiguring services was reviewed by an Independent Reconfiguration Panel (IRP)

The IRP were of the view that children and adults with Congenital Heart Disease (CHD) in England and Wales would benefit from services commissioned to national standards for the whole pathway of their care. They agreed that congenital cardiac surgery and interventional cardiology should only be provided by specialist teams large enough to sustain a comprehensive range of interventions, round the clock care, training and research.

As a result all Paediatric Cardiac activity (surgery and cardiology) taking place in the Specialist Children’s Surgical Centres and Specialist Children’s Cardiology Centres is covered by the Paediatric Congenital Heart Disease Services Specification.

The Service Specification states that patients with significant congenital heart disease should be discussed at combined Multi Disciplinary Team meetings (MDT), including all patients being considered for surgery or innovative procedures. The Standards also provide for minimum numbers of surgical/interventional procedures to be carried out by each paediatric cardiac surgery unit.

The Paediatric and Congenital Cardiac Services Review Group published its report in December 2003. In its report, the Review Group stated that this approach would be unduly restrictive.