The controversial review of children’s heart surgery at hospitals in Leeds and Newcastle pitched them into an acrimonious competition, damaging both patients’ parents and practitioners’ trust.
This is the conclusion of one of two reports released this week into paediatric cardiac surgery services at Leeds Teaching Hospitals Trust.
The reports by consultancy Verita can provide lessons for future restructuring of children’s heart surgery, NHS England says.
The row was triggered by the now abandoned Safe and Sustainable Review, which recommend 11 paediatric heart surgery services across England should be reduced to seven.
It proposed in July 2012 that the service run by Leeds Teaching Hospitals Trust should be closed, while leaving the one run by Newcastle to carry on operating.
Leeds’ service was then suspended by NHS England the following March after the commissioning body became concerned about mortality data supplied by the National Institute for Cardiovascular Outcomes Research, a research centre attached to University College London.
A 13 day suspension was imposed one day after the High Court quashed the review’s decision to close the service in Leeds, following a case brought by campaign group called Save Our Surgery.
After the service resumed, clinicians in Newcastle came forwards with further concerns about 14 patients who had been referred to the hospital by Leeds.
While the reports concluded that while NHS England had correctly suspended the service “in the best interests of patient safety”, its authors’ criticised Newcastle’s attempt to intervene.
The commissioning body had acted on “incomplete data” but its medical director Sir Bruce Keogh “had to act promptly” after receiving the information from NICOR, they concluded.
Newcastle had however “compressed the period of the concerns in a way that put Leeds in an unfairly poor light”, one of the report says.
“If Newcastle thought that patients had come to real harm at Leeds they should have taken action as their concerns crystallised, rather than collecting evidence for later reporting,” it adds.
The same report criticised Leeds for shortcomings in the way it submitted mortality data.
“Inaccurate data are worse than useless and can be positively damaging,” it says.
“At Leeds, incomplete information was instrumental in causing the suspension of surgery and great consternation both at the hospital and in the community it serves.”
The report recommends all NHS organisations “give the accuracy and completeness of their data a high priority”.
NHS England’s deputy medical director Mike Bewick said the service at Leeds had been “rigorously scrutinised” and “has improved as a result”.
He added: “Not only have we learned about the service in Leeds, we have learned lessons of relevance nationally.
“We are currently consulting on new standards for children’s heart surgery across the country and the review in Leeds has made a significant contribution.”
Sir Leonard Fenwick, chief executive of Newcastle upon Tyne Hospitals Foundation Trust, defended its decision to intervene.
In each of the 14 cases it put forward, the children had “either not been offered surgery or faced delays or been placed on palliative care pathways”, he added.
“Despite the underlying complexity and high risk involved each and every child underwent surgery in Newcastle with a successful outcome.
“Disappointingly the Verita report has chosen to disregard this important factor.
“Newcastle Hospitals as an NHS foundation trust exercised freedom and a responsibility to patients and the NHS to fulfil the duty of candour, that for whatever the prevailing circumstances, were not receiving the appropriate care and treatment.
“We can give a categorical assurance that our aim then, as it is now, reflects an unstinting commitment to improve pathways of care including choice where appropriate.
“We as an organisation strive to effectively network across the Children’s Heart Centres of the United Kingdom, including Leeds General Infirmary, and remain highly committed in this regard.”
Yvette Oade, chief medical officer at Leeds Teaching Hospitals Trust, said: “I am pleased to be able to reassure patients and families, our staff and the public that that the unit in Leeds provides safe care and is running well, reinforcing the findings of previous reviews.
“We recognise that in a small number of specific instances over a 10 year period, the report finds our unit did not match the high standards our patients rightly expect – this is not acceptable and we apologise to those families.
“We now believe it is right and timely to strengthen the network of clinicians and NHS hospitals in the north of England who care for children with congenital heart disease and we are keen to play a strong role in this important work.”