Agenda item

To receive and consider a report from the Head of Scrutiny and Member Development providing an update on service provision at Leeds Teaching Hospitals NHS Trust, specifically in relation to children’s congenital heart services.

The Head of Scrutiny and Member Development submitted a report which provided an update on service provision in relation to children’s congenital heart services at Leeds Teaching Hospitals NHS Trust.

The following information was appended to the report:

-  Copy of the letter dated 21 March 2013 inviting the Chief Executive of the Children’s Heart Federation to attend the Joint Health Overview and Scrutiny Committee on 10 April 2013

-  Statement by Leeds Teaching Hospitals Trust dated 27 March 2013 outlining its decision to temporarily pause children’s cardiac surgery and associated interventions following discussions with senior representatives from NHS and the Care Quality Commission earlier that day

-  Copy of an email dated 28 March 2013 from the Chair of the Central Audit Database Steering Committee to the Chair of the National Institute for Clinical Outcomes Research (NICOR) Executive Committee

-  Statement by the British Congenital Cardiac Association dated 1st April 2013.

The following representatives attended the meeting:

-  Mike Bewick, Deputy Medical Director, NHS England

-  Andy Buck, Director for West Yorkshire Area Team, NHS England

-  Maggie Boyle, Chief Executive of Leeds Teaching Hospitals NHS Trust

-  Stacey Hunter, Divisional General Manager of Leeds Teaching Hospitals NHS Trust

-  Rod Hamilton, Compliance Manager, Care Quality Commission.

The key areas of discussion included:

·  Issues accessing information and data from NHS England.  Particular reference was made to the document ‘NHS England Review of Children’s Congenital Cardiac Surgery Service at Leeds Teaching Hospitals NHS Trust’.  Mike Bewick, Deputy Medical Director, NHS England, advised that the document referred to was subject to final amendments and had only recently been made available for public disclosure.

·  Clarification whether Children’s Congenital Heart Services at Leeds were safe.  Maggie Boyle, Chief Executive of Leeds Teaching Hospitals NHS Trust, stated that Leeds was as safe as any service across the country.  No major or medium risk areas had been identified, however, there were some issues associated with data and terminology which had been identified as low risk, low impact.

·  Members queried whether the pause in children’s cardiac surgery was premature and whether a review of proper evidence should have been undertaken first.

·  The Deputy Medical Director, NHS England, advised that there were 3 aspects to the decision:

1)  Provisional data analysis supplied by NICOR;

2)  Intelligence provided by the Children’s Heart Federation (CHF);

3)  Intelligence provided by 2 whistleblowers.  One from another hospital and one internally concerned about staffing levels.

·  The Deputy Medical Director, NHS England, emphasised the need to be provided with accessible, timely data, although not at the expense of quality.

·  Concern that the closure had affected the credibility of Leeds and resulted in increased scrutiny.

·  Andy Buck, Director for West Yorkshire, NHS England, advised that 3 Area Care Quality Commissions were being established in Yorkshire and the Humber involving a range of health representatives.

·  Acknowledgment of Members’ concerns regarding the role of Healthwatch, and its involvement as part of the risk summit.

·  Confirmation that the Children’s Heart Foundation had expressed concerns to The Care Quality Commission (CQC).  No action was taken on the basis of the information and data supplied.  The CQC had every confidence in Leeds and the processes in place.

·  Confirmation that issues associated with the delivery of data had been resolved internally, although there were wider governance issues that required further considerations.

·  Clarification in relation to locum arrangements.  2 experienced surgeons were employed at Leeds.  Due to the uncertainty surrounding the future of the service these had been identified as locum posts.  Members were advised that these posts were in the process of being made permanent.

·  The consequences of closing Children’s Congenital Cardiac Surgery Services at Leeds.  Members were advised that there were 10 children requiring transfer to be assessed.  The children were accommodated elsewhere on the basis of availability.  6 were transferred to Leicester, 2 to Newcastle, 1 to Alder Hey (Liverpool) and 1 to Birmingham.  LTHT had worked closely with the regional paediatric transport service (Embrace) to ensure appropriate transfers were undertaken in a timely manner. During the closure, LTHT had provided daily reports to NHS England, the Care Quality Commission and the NHS Trust Development Authority.

RESOLVED – That the contents of the report and appendices be noted, and that members of the JHOSC would be provided with the finalised reports/ information discussed at the meeting – in particular the finalised report from the external review team / risk summit, and the analysis of mortality from paediatric cardiac surgery undertaken by NICOR.

(Councillor J Clark withdrew from the meeting at 1.10pm at the conclusion of this item.)