As a resident of Leeds, a professional in the healthcare sector and a member of the Leeds Hospitals Trust it would be a understatement to say that I am interested in the recent saga of childrens cardiac surgery at the Leeds Hospitals NHS Trust.
As you may recall if you followed the news items the story first came to light over the Summer of 2012 when the proposal was made to stop childrens cardiac surgery in Leeds and transfer the specialty to a new centre of excellence in Newcastle, the change was based on reducing cost and enhancing clinical care. This suggestion though has been fought strongly, firstly via a petition (with over 600,000 signatures) then in court by a pressure group including current and former patients families who felt the treatment for their kids should remain in West Yorkshire. In the end the fight culminated in court with a Judicial Review supporting the patients families in so much as the decision to move to Newcastle was deemed unlawful due to a failure of the NHS to disclose full scoring on the unit for protestors to counter during the initial review. This at the very least made any decision to close the Leeds unit dubious and would delay and potentially stop any move. This legal decision was made in late March 2013
This was classed as a ‘victory’ by protestors and in their terms I suppose it was, but of course within a couple of days former ‘Heart Tsar’ and now Director of the National Institute for Clinical Outcomes Research (an organisation which oversees mortality statistics within the NHS ) : Sir Roger Boyle spoke out saying that clinical outcomes (i.e. mortality) in Leeds were twice as bad as other surgical centres. The information was sent to Sir Bruce Keogh – NHS Medical Director and of course this put the ‘cat amongst the pigeons’ as it now looked as if both the High Court decision was wrong, there were senior NHS figures who appeared openly opposed to the continuation of Leeds as a paediatric cardiac surgery centre (otherwise why release the information two days after the High Court review) and a media storm that dragged in political figures and as always left the public unsure of who was telling the truth and vitally begged the question : is heart surgery for kids in Leeds safe ?
I cannot answer that question, of course the Trust immediately suspended all surgery in this area pending a review but then the plot thickened. The figures disclosed to Keogh were then revealed on the 30th of March 2013 as being possibly dubious – cardiologist Elspeth Brown claimed the figures sent by Boyle to Keogh were in fact preliminary and did not cover all the operations carried out within the unit so had been improperly analysed – she claims that the Leeds unit safety record was well within required parameters and that mortality figures were exactly what one would expect from this type of medical unit.
Further media revelations included the potentially damning insight that ‘junior’ consultant surgeons were left in charge without adequate senior supervision – however it then transpired the two were still full consultants who although ‘junior’ were in fact experienced surgeons in their own right.
A bit of a mess I’m sure you would agree ?
The problem I feel with the whole situation is not if the unit should remain in Leeds, or whether one surgeon or unit has a worse record than any other but rather that the clinical data on which decisions – like the the Judicial Review and the cancellation of surgery in Leeds and the statements made by interested parties (surgeons, clinical directors, local NHS managers, the media and so on) are based on data not widely available in the public arena. In other words, as an interested member of the public I am unable to formulate a cogent opinion on the rights and wrongs of this situation and this is made all the more ludicrous because the decision involves public funds and the standard of care offered by the NHS which is after all a publicly funded body. In essence I’m questioning the information put out by the NHS and the politicising of this limited information by the media and others.
As an aside on the closure of the unit itself, here is where I stand (if you are interested) : If the clinical outcomes for sick children would be better in one location then that is where the surgery should be performed. Full stop. To me it is a simple equation (as a father of two myself) who provides the best treatment and care for my children ? This is why accurate publically available information and statistics are so important to enable users of clinical services to make informed decisions.
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