• St George’s loses roughly £11m from loss of complex cardiac surgery
  • Unit is at centre of row over governance, quality and relationships
  • A review of deaths over past five years is ongoing
  • Loss of income and increased costs responsible for roughly half of worsened deficit, trust says

Dispute and concerns over care quality at a teaching hospital’s surgical unit have cost it £11m, its finance director has revealed.

Referrals for complex work stopped being sent to St George’s Hospital cardiac unit in September after a review of the service, and animosity among the surgeons and management.

One surgeon, whose suspension was overturned after she took a legal case, alleged in court papers that she received personal abuse including a dead animal posted to her address, during a long-running dispute within the six-surgeon team.

At a meeting of the board of St George’s University Hospitals Foundation Trust on Thursday finance director Andrew Grimshaw said the trust’s end-of-year deficit had worsened from £33m to £55.6m, and that roughly half of this was from disruption to the cardiac work.

He said most of the difference came from loss of income, although there were some extra costs from hiring locum staff.

The service is now being reviewed by an NHS Improvement-appointed panel examining whether there were more deaths than expected between 2013 and 2018 and a review of governance is being led by Sir Andrew Cash, a former top trust chief executive. The service was temporarily managed by Guy’s and St Thomas’ Foundation Trust and is still supported by senior staff from GSTT and King’s College Hospital Foundation Trust.

Surgical trainees were also withdrawn from the trust in September.

A new associate medical director, Steven Livesey, was appointed from Southampton in December.

Board papers said Mr Livesey was undertaking his own review “to consider taking back some of the more intermediate complexity cases”.

Problems in the team date to at least 2010, but the National Institute for Cardiovascular Outcomes Research first told the trust its mortality rates were higher than expected in spring 2017.

An external review of the service published last year, the Bewick review, found deep dysfunction persisted within the heart surgery team and said it could lose the service entirely if it did not take drastic steps to reform the consultant team, as first revealed by HSJ in July.

The south London trust has a turnover of about £820m and employs around 8,000 staff.

Source

Board meeting

Source Date

January 2019

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