Intended for healthcare professionals

Rapid response to:


Radcliffe should stop doing children’s heart surgery, review recommends

BMJ 2010; 341 doi: (Published 19 October 2010) Cite this as: BMJ 2010;341:c5863

Rapid Response:

Re:Bottom of the league

Dr Braithwaite is wrong to suggest that the NHS review of children's
congenital cardiac services has referenced a 'league table' of services
and he worryingly misunderstands the case for reconfiguration of services

All 11 surgical centres in England have been assessed against their
ability to meet new quality standards. The standards have been developed
and endorsed by the relevant professional associations including the Royal
College of Surgeons, the Royal College of Nursing, the Society for
Cardiothoracic Surgery in GB+I, the Royal College of Paediatrics and Child
Health, the British Congenital Cardiac Association and the Paediatric
Intensive Care Society. It is also endorsed by the Childrens Heart

The process has involved rigorous on-site assessments by an independent
expert panel chaired by Professor Sir Ian Kennedy together with an
evaluation of other relevant criteria.

There is overwhelming clinical support for the proposition that 11
children's congenital cardiac services in England is too many and that
fewer, larger surgical centres will lead to better quality of care,
including better outcomes, for children with congenital heart disease and
their families in the future. We recognise that reducing the number of
centres undertaking surgery will involve very difficult decisions but that
is the way forward.

Competing interests: I no longer undertake paediatric cardiac surgery

04 November 2010
Leslie Hamilton
cardiac surgeon
Society for Cardiothoracic Surgery