‘Dark force’ heart surgery unit no longer on mortality ‘alert’

The National Institute for Cardiovascular Outcomes Research confirmed the unit at St George’s Hospital was no longer in “alert” status, in its most recent publication.

The south London foundation trust had received two alerts over its results, in May 2017 and April 2018. NICOR alerts are published by the Society for Cardiothoracic Surgery when a unit’s mortality results are two standard deviations below the national mean. The most recent publication came in September, but has not previously been reported.

It follows high-profile concerns and disputes involving the unit in recent years. 

In May the trust reached an out of court settlement with surgeon Marjan Jahangiri, in a case in which she claimed the trust unfairly suspended her in response to an allegation she had interfered in another investigation.

The conflict at the unit was characterised as a “dark force” and a “persistent toxic atmosphere” in a report commissioned by the trust and revealed in 2018. The full, unredacted report has never been released.

Meanwhile, court papers alleged disputes between staff had seen Professor Jahangiri sent a dead animal through the post.

In response to the external review, carried out by former NHS England deputy medical director Mike Bewick, and fallout from it, the trust suspended complex procedures at the unit, brought in external management from other trusts and NHS England/Improvement convened a panel of outside experts to review all deaths at the unit between 2013 and 2018. The latter two external processes are ongoing.

An update to the trust’s board last month on its progress following the Bewick review said the unit was rebuilding the size of its caseload and was currently seeing 750 patients a year and “our hope and expectation is that this number will rise as the unit continues to stabilise”.

The loss of complex surgical work cost the trust £11m in lost revenue, it said earlier this year.

The department is now led by Steve Livesey and a trust spokesman confirmed Professor Jahangiri still worked at the organisation.

In a statement, the trust’s chief medical officer Richard Jennings said: “Our focus remains on providing safe, high quality care for our cardiac surgery patients, and the latest NICOR data confirms that our outcomes are now back within the expected range.

“We have put in place a number of improvements, including multidisciplinary reviews of all patients referred for cardiac surgery, and the appointment of Mr Steve Livesey, cardiac surgeon, as clinical lead for the service and associate medical director.

“We are not complacent, however, and the organisation remains clearly focussed on delivering further improvements in cardiac surgery at St George’s, for the benefit of patients and staff.”