• Leicester and Royal Brompton promise to challenge NHS England plans to reconfigure congenital heart disease services
  • NHS England decision would see both trusts lose most complex “level one” proceedures
  • The trusts warn that the loss would destabilise other key services

Two trusts that stand to lose services under NHS England’s plans for restructuring congenital heart disease treatment have challenged the commissioner.

University Hospitals of Leicester Trust’s chief executive said his organisation would “use all the means at our disposal to reverse this intention”.

In a letter to NHS England, John Adler criticised the methodology used to calculate which hospitals should perform the most complex, “level one” procedures, and said removing the service from Leicester would render other parts of the trust unviable.

The Royal Brompton and Harefield Foundation Trust will also see its level one services transferred to other providers under the plans announced by NHS England this morning.

In 2011 the trust took a commissioning group set up by the Department of Health to court to overturn a decision that would have seen it lose paedatric congenital heart disease surgical work.

In a statement issued yesterday, the Royal Brompton’s chief operating officer Robert Craig said: ”We find NHS England’s stated intention extraordinary. We fail to see how any logical review of the facts will come to the same conclusion as this panel.

”The consequences of this decision, should it be implemented, would be far-reaching and would affect not only congenital heart disease services for adults and children but also paediatric intensive care: if paediatric cardiac services were moved from Royal Brompton, our paediatric intensive care unit would no longer be viable because of the drop in volume of patients needing such expertise. In turn this would adversely affect our specialist respiratory services, many of which cannot be delivered without the back-up of a specialist intensive care service.”

NHS England said a consultation would be undertaken before any changes took place.

Mr Adler said that when the latest National Institute for Cardiovascular Outcomes Research data was published in October he was confident Leicester’s would be among the best in the country.

He added that the figure NHS England was using - that surgeons should perform 125 procedures a year - would be hit over the next three years, but that recent research by the School for Health and Related Research in Sheffield found that ”whilst a relationship between volume and outcome exists, this is unlikely to be a simple, independent and directly causal relationship.”

Central Manchester University Hospitals Foundation Trust was also told by NHS England that it would not continue to provide level one services and that the commissioning body ”will take enforcement action should this be necessary to ensure transfer.”

The trust had not made any comment as HSJ went to press.

Three trusts set to lose specialist heart surgery