• GSTT stopped transplant referrals to King’s College Hospital after “breakdown in trust”
  • Not clear if harm review process initiated

A “breakdown in trust” between two of the country’s leading teaching hospitals saw transplant patients referred elsewhere as a result of safety concerns, HSJ can reveal.

The King’s Health Partners blood and marrow transplant programme is run by Guy’s and St Thomas’ Foundation Trust and its neighbour King’s College Hospital FT. A dispute between the two London giants began last year centring on “prolonged engraftment” - a potential clinical indicator of a problem with the transplant. 

As a result of the relationship breakdown, GSTT referred some transplant patients to other trusts instead, including University College London Hospitals FT and the Royal Marsden.

In a joint statement the trusts told HSJ the suspension of transfers concerned a “small number of patients”, though they would not say how many.

It added: “Concerns around prolonged engraftment have been reviewed and engraftment times are now within the normal range. National quality indictators do not indicate any areas of concern with the KHP programme.”

Asked if a harm review had been undertaken and what it had concluded, the trusts said in a further statement: “Data for the transplant programme showed that engraftment times for some patients were longer than expected. A subsequent quality review found that, based on patient risk profile, there was no evidence of excess mortality and outcomes continue to be within expected standards, and we continue to monitor this through the quality review group.

“Transplant referrals are on a case-by-case basis based on a patient’s disease profile, where they live and their individual preferences. While patients were still referred to King’s College Hospital, there was a decrease in overall referral levels.”

The statement continued: “A cross-partner quality review group was established to provide joint oversight of continuous quality improvement. The group was initially chaired by [former Marsden chief nurse] Shelley Dolan and will in future be chaired by Professor Nicola Ranger, chief nurse at King’s College Hospital. The group continues to oversee the joint development of the programme to ensure ongoing improvements to collaboration and integration.”

Minutes of the GSTT July cancer services committee meeting, released this week, said GSTT’s clinical director Claire Harrison had reported the “one team” workstream at the KHP haematology institute was “progressing well” on transfusion and BMT pathways. The document said this “important piece of work focussed on behaviours and culture”.

A report on the subject was made to KCH’s quality committee, also in July. Minutes of the meeting, published this month, said: “The committee was pleased that the report, which was simultaneously presented to the GSTT board, described significant progress on resolving the matters of dispute that had arisen, and expressed the wish that there would be significantly greater cooperation between the teams in the future.”

King’s Health Partners, the academic health science centre charged with aligning the aims of the trusts and King’s College London university, had not provided a comment as this article went to press.

HSJ reported last November that KCH had failed in its bid to win national support for a new haematology research centre at the trust’s main site.