Written Ministerial Statement

The content of this written ministerial statement is as received at the time from the Minister. It has not been subject to the official reporting (Hansard) process.

Department of Health, Social Services and Public Safety - Paediatric Congenital Cardiac Surgery Services

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Published on Thursday 29 March, 2012

Mr Poots (The Minister of Health, Social Services and Public Safety): I wish to make a statement to the Assembly following notification from the HSC Board that it plans to carry out an external review of paediatric congenital cardiac Services.

I am advised by the HSC Board that it plans to commission an external review of the paediatric congenital cardiac service in Belfast. Paediatric congenital cardiac surgery is a highly complex specialist service which carries a significant risk. Congenital cardiac disease is a rare condition. Currently the service in Belfast is provided by a highly skilled and dedicated team including surgeons, cardiologists and nurses.

We recognise that such a highly complex specialist service is inherently vulnerable mainly because of the low activity levels. As a result there are significant challenges in attaining and sustaining quality against rising standards. Standards for this service are increasing across the UK with a move towards surgeons working in larger teams delivering higher volumes of activity. Available evidence and professional consensus is that larger teams deliver better outcomes. In light of these increasing standards we need to consider how we deliver the best service for children in Northern Ireland.

The external review to be commissioned by the Board will consider the current service provision, activity, outcomes and sustainability of the paediatric congenital cardiac service and will provide assurance on the quality of services for patients in Northern Ireland

It is important to recognise that in such a highly complex specialty, not all children will survive. Across the UK, there is a mechanism in place where surgical outcomes are reported to the Central Cardiac Audit Database (CCAD). This enables health professionals to continually measure and improve care by comparing their work to specific standards and national trends.

The CCAD report for the period 2007-2010 indicated a higher than expected mortality for one particular procedure, undertaken at the Belfast Health and Social Care Trust, on children suffering from a disorder known as Tetralogy of Fallot, which is a serious heart abnormality, The Trust took appropriate and proportionate action by suspending Tetralogy Repair when the CCAD data was made available in September 2011.

I understand that in the context of the CCAD report for 2007-2010 and following validation of the outcomes and an internal review, the Belfast Trust also plans to seek a more detailed review into the outcomes during that period. The Trust has confirmed that it will invite the Royal College of Surgeons to conduct a review of those outcomes as advised by the Society of Cardio Thoracic Surgeons and the British Congenital Cardiac Association. It is entirely appropriate that the Trust would wish to take a more in-depth look at the higher than expected mortality for that procedure during that period.

The Belfast Trust review will be carried forward in addition to the HSC Board’s external review of the wider paediatric congenital cardiac service.

I am conscious parents of children suffering from congenital cardiac problems may be anxious about these reviews. It is important to remember that the CCAD report has highlighted one procedure out of over 30 cardiac surgical procedures carried out on children across the UK. This procedure is currently not being carried out here and any children who need this surgery are being referred to other centres.

I wish to reassure families that the Board and the Trust are acting appropriately to ensure the provision of high quality, safe services for these children.

The Belfast Trust has established an advice line for any parent who is concerned. Free phone 0800 9178226. This advice line will be staffed from 5.00pm this afternoon (29th March) until 9.00pm this evening and again from 8.00am to 6.00pm tomorrow (30th March).