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Children's heart surgery review published

Fergus Walsh | 15:15 UK time, Wednesday, 16 February 2011

The long-awaited review of children's heart surgery has finally been published, and as widely predicted, it suggests that at least four centres stop operating.

The fewer, bigger, better argument is accepted by all professional bodies. But the units facing the loss of surgery will be deeply unhappy. The review team presents four options - from A to D. Just four units are certain to survive the review procedure. Bristol, Liverpool and Birmingham are named in each option whilst Great Ormond Street in London is guaranteed to continue as a cardiac centre because its national role in other key services such as transplant and tracheal surgery.

All the other units are faced with another six months of uncertainty before a final decision is made. In London, the review team say the number of units should reduce from three to two and name the Evelina Children's Hospital over the Royal Brompton as their preferred centre.

Looking at the documents, one can't doubt the huge amount of work and analysis which has gone into this. Each unit is rated in a number of different ways. And every unit, bar Oxford, continues to survive in at least one of the scenarios. But this may give false hope to units like Leeds, which looks very unlikely to retain its surgery status. Some might argue that it would have been better for the review team to be more prescriptive and actually list the units they think should no longer do surgery rather than this variety pack scenario.

These are the four options for the future of children's heart surgery:

A: Newcastle, Liverpool, Leicester, Birmingham, Bristol +2 in London
B: Newcastle, Liverpool, Birmingham, Bristol, Southampton +2 in London
C: Newcastle, Liverpool, Birmingham, Bristol +2 in London
D: Leeds, Liverpool, Bristol, Birmingham +2 in London

You can see that A and B contain seven units while C and D contain 6 units. The final decision will be made in the autumn by a national committee representing all Primary Care Trusts. I am advised that it would be highly unlikely that they would opt for six units, ruling out C and D.

That means it is a straight choice between Southampton and Leicester. In London, the Royal Brompton will mount a spirited defence of its role as a paediatric surgical centre. If it loses heart surgery for children, then its paediatric intensive care unit will probably no longer be viable.

The changes will take a couple of years to happen. But many will argue that they are already a decade overdue.

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