News

Doctors at Newcastle made unfounded complaints about children’s heart surgery at Leeds, finds report

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6528 (Published 29 October 2014) Cite this as: BMJ 2014;349:g6528
  1. Clare Dyer
  1. 1The BMJ

An independent report for NHS England on the events surrounding a 12 day suspension of children’s heart surgery at Leeds Teaching Hospitals NHS Trust has criticised doctors at the rival centre in Newcastle whose phone call partly triggered the closure.1

NHS England’s medical director Bruce Keogh asked the Leeds trust to suspend the services on 28 March 2013 after being alerted to worrying preliminary mortality data. A leading Birmingham surgeon had also raised concerns about consultant staffing shortages at the Leeds trust, and a senior paediatric cardiac surgeon at the Freeman Hospital in Newcastle had cast doubt on the safety and quality of services at the Leeds unit.

At the time, Leeds and Newcastle units were in contention to provide children’s heart surgery services for the north of England under a plan to cut the number of units delivering the services from 10 to seven. The “Safe and Sustainable” review had determined that the Leeds unit should close, but Leeds campaigners had won a High Court case branding the review flawed.2

The Safe and Sustainable review has since been scrapped and a new review, under which all the services could remain if they meet certain standards, has been opened for consultation.3

Services at the Leeds unit resumed on 10 April after further mortality data showed that the service was operating within safe levels, and the two locum consultants were found to be suitably qualified and experienced. But Keogh asked the Newcastle upon Tyne Hospitals NHS Foundation Trust for evidence backing up its concerns, and Leonard Fenwick, chief executive of the trust, sent a 14 patient dossier to Mike Bewick, NHS England’s deputy medical director.

The new report for NHS England, by independent consultancy Verita, criticised the Newcastle trust for passing on unsubstantiated complaints based on patients’ accounts rather than clinicians’ concerns, and including cases dating between 2005 and 2013, when Keogh had been told the concerns were recent.1 In some of the cases the parents were campaigning for services to be transferred to Newcastle.

In a separate report examining the allegations in the dossier Verita found two cases where risk assessment at Leeds had not been satisfactory, two cases in which there was an unnecessary delay in seeking second opinions or making referrals, and five cases of failure in communication.4

The Newcastle trust had characterised its own action as whistleblowing, said the report, but “reporting the unchecked allegations of others is not whistleblowing, and Newcastle should have made the status of their concerns clearer when they reported them.” The Verita report found no evidence that Leeds was reluctant to refer patients to Newcastle or other centres.

Newcastle upon Tyne NHS Foundation Trust said in a statement, “The report is about 14 complex cases where the child was either not offered surgery or faced delays or [was] placed on palliative care pathways. Despite the underlying complexity and high risk involved each and every child underwent surgery in Newcastle with a successful outcome. Disappointingly the Verita report has chosen to disregard this important factor.”

Verita said the competition set up by the Safe and Sustainable review process had damaged the trust and confidence that used to exist between practitioners and “damaged the trust that some parents had in the neutrality of the advice given to them by those treating their children.” As part of the new review, NHS England should act to dispel the “almost morbid sense of spectatorship and foreboding that hangs over these services.”

Notes

Cite this as: BMJ 2014;349:g6528

References

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