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Safe and Sustainable Paediatric Cardiac Surgery Services Programme

Safe and Sustainable Paediatric Cardiac Surgery Services Programme. Jeremy Glyde Programme Manager NHS National Specialised Commissioning Team. Scope. paediatric surgical services paediatric interventional cardiology services interdependent services … in England.

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Safe and Sustainable Paediatric Cardiac Surgery Services Programme

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  1. Safe and SustainablePaediatric Cardiac Surgery Services Programme Jeremy Glyde Programme Manager NHS National Specialised Commissioning Team

  2. Scope • paediatric surgical services • paediatric interventional cardiology services • interdependent services … in England

  3. Previous Reviews and Recommendations Kennedy Report, 2001 (the Bristol Royal Infirmary Inquiry) Paediatric and Congenital Cardiac Services Review Group, 2003 (the Monro report) Professor Boyle and Dr Shribman workshop, 2006

  4. “I am writing formally to request that the National Specialised Commissioning Group undertake a review of the provision of paediatric cardiac surgical services in England with a view to reconfiguration”. Professor Sir Bruce Keogh NHS Medical Director May 2008

  5. NHS Levels of Commissioning National Specialised Commissioning Group • Examples • Transplants (except renal) • Rare cancers • Rare neuro-muscular • 50 million people • Paediatric cardiac/neuro-surgery • Severe burn care • Cleft lip & palate • 5 – 50 million people • Children & young peoples’ cancers • Haemophilia • Renal transplants • 1 – 5 million people • General acute medicine/surgery(e.g. hip replacements) • 100,000 – 1 million people • Minor surgery • Endoscopies • District nursing • Less than 100,000 people National NCG Supra-Regional Specialised Commissioning Groups Regional Specialised Commissioning Group Local (PCT) Practice Practice-based commissioning

  6. NSCG membership • Chaired by Chief Exec of London SHA • Chairs of 10 SCGs (Chief Execs of PCTs) • Lay representation • Department of Health • President, Royal College Pathologists • President, Royal College Physicians • Chair of National Commissioning Group • Director, National Specialised Commissioning • Observers from Scotland / Wales / NI

  7. Safe and SustainablePaediatric Cardiac Surgery Services

  8. Why Now? • Sub-specialisation within field of surgery • Training and mentoring in surgical teams • Working time legislation (limits hours) • Critical mass of procedures

  9. Why now? Difference in surgical procedures (largest centre measured against smallest centre) 2002/03 = 434 procedures 2007/08 = 496 procedures

  10. Steering Group membership • Children’s Heart Federation • British Congenital Cardiac Association • Association of Cardiothoracic Anaesthetists • Society for Cardiothoracic Surgery in Great Britain and Ireland • Royal College of Paediatrics and Child Health • Paediatric Intensive Care Society • NHS commissioners • NHS in Scotland and Wales • NHS public health doctors

  11. Principles • The NHS must provide only the very highest standard of care for children and their families, regardless of where they live or which hospital provides their care. • Centres should provide care that is based around the needs of the child and the family and which takes account of the transition to adult services. • All relevant treatment other than surgery, including follow up, should be provided as locally as possible to the family. • Clinical standards should be agreed and met by all centres.

  12. Terms of Reference • Develop criteria for the designation of specialist paediatric congenital cardiac services • Agree a national quality framework via clinical standards for paediatric congenital cardiac services • Identify and address the financial and workforce implications of service reconfiguration • Identify cross boundary issues facing service provision for the devolved administrations that are affected by commissioning decisions in England

  13. Who makes the recommendations?

  14. SCG Collaboratives

  15. The recommendations • Recommendations and viable options for change • Assessment of the options • Impact to other services? • Evidence base • Financial case • Implementation strategy • Consultation strategy

  16. Key project milestones

  17. Draft standards • Network approach • Prenatal screening • Making choices • Patient and family experience • Access to services • Age appropriate care • Excellent care • Team delivered • Safe and sustainable

  18. How can you get involved? • CHF Federation Day 12/09/09 • Ipsos MORI survey • NHS Stakeholder Event 22/10/09 • Comment on draft standards • Talk to us .... • Write to us .... • www.nscg.nhs.uk

  19. Nationally designated children’s services (cardiothoracic) • Heart and lung transplantation (2 centres) • Mechanical bridge to heart transplant (2 centres) • ECMO for respiratory failure (3 centres) • Pulmonary hypertension (1 “hub” centre and 6 regional centres) • Complex tracheal (1 centre)

  20. NCG membership Lay representation Presidents of Royal Colleges of: • Paediatrics • Pathologists • Physicians • Psychiatrists • Surgeons

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