Royal Brompton loses reconfiguration case at the High Court

The Royal Brompton and Harefield, a specialist heart and lung trust, last year got the process for determining which sites should remain surgical centres for the work quashed, with the judge ruling the assessment had not taken proper account of the London hospital’s research strengths.

But an appeal brought by the Joint Committee of Primary Care Trusts, a Department of Health-mandated organisation, saw that decision overturned this morning.

The decision handed down by the judges said: “We wish to leave open the question whether, even on the [original] judge’s conclusions, it was correct for [him] to quash the whole of the consultation.”

The case was the first time a foundation trust has used its independent status to challenge a centrally-run consultation process.

The £287m-turnover specialist organisation now faces court costs of £1.5m and has confirmed it will not be appealing.

The Royal Brompton’s case was that the consultation options for reconfiguring the services nationally unfairly excluded it from consideration by only including two London sites, the Evelina Hospital - part of Guy’s and Thomas’ Foundation Trust - and Great Ormond Street Hospital for Children FT.

The Royal Brompton had said losing child heart surgery would have knock-on effects on its other services that would render it unviable.

Sir Neil McKay, who chairs the JCPCT, said the decision had “vindicated” the consultation process and he would not have done anything differently.

Sir Neil told HSJ the case showed “the consultation process is where [providers] should raise their concerns. It’s a really important judgment for commissioners and providers”.

“If this had gone the other way we would have taken account of the verdict of the court but we would have consulted again, be in no doubt,” he said. “The court has said we don’t need to do that because we did everything properly in the first instance. It’s regrettable that this action has delayed our work by a number of months.”

In a statement he said allegations that the JCPCT’s framing of the options had been biased because clinicians from the Evelina and Great Ormond Street sat on its steering committee had been “hurtful” and “personally distressing to the doctors”.

The initial judgment in November rejected this accusation.

There will now be a public meeting on 4 July where the options, including three London surgical centres will be discussed.

Sir Neil added: “It is possible that my committee will be swayed by the arguments on that day.”

Papers giving more details about the options are due to be released a week before the meeting.

In a statement the Royal Brompton said: “We remain of the view that the decision to close a London centre such as ours was not made on purely clinical grounds.

“The minutes of the London Specialised Commissioning Group, part of the JCPCT, from 26^th April 2010 state: ‘It is likely that the rest of the country will take a view that London should take its share of the pain of closures and will seek to make one closure in the capital in order to make closures elsewhere more palatable’.

“Our position remains that the number of patients referred in to the capital warrants a network system comprising the three current centres. We already work closely and successfully with both Great Ormond Street and Guys and St Thomas’ and hope to continue discussions with them on setting up such a network arrangement.”