Childrens Cardiac Surgery is Relevant to GUCHs

By Michael Cumper, Chairman of the GUCH Board of Trustees

You might have heard on the news that there is a review being carried out of paediatric cardiac surgical centres. It is referred to as the Safe and Sustainable review and is the result of much discussion over many years.

It is generally accepted that the number of hospitals carrying out children's cardiac surgery needs to be reduced. At the moment there are 11 centres, with approximately 30 surgeons carrying out around 3800 procedures per year. It is unlikely that the number of procedures will vary significantly in the years to come.

Two key issues lie behind the recommendations:

• Skills of the surgical team. Heart surgery centres that carry out a higher than average number of surgical procedures perform better, as surgeons become more experienced/specialised.
• Availability of surgeons. To ensure that surgeons do not work excessive hours and operate when tired, a new European Working Time Directive limits the number of hours a surgeon can work. To comply with this law and ensure that there is full cover, each centre will need at least three, but probably five surgeons.

So why is this important to GUCH? The surgeons who operate on children's hearts are in effect surgeons operating on patients with congenital heart defects and the same surgeons that carry out many of the surgical procedures carried out on GUCHs. It is therefore very important for us that they can work as effectively as possible too. GUCH PA is therefore very supportive of the Safe and Sustainable review.

However, the purpose of the review is to recommend a reduction in the number of centres operating on children and, therefore, it might be the case that some surgeons move from where they currently are. There is no point in trying to second guess the outcome of the review, but I met with the Department of Health to make it clear that we will have comments to make as soon as any draft of the review is available. I am hopeful that the review will have limited impact on GUCH services as there are already fewer hospitals which we consider GUCH Specialist Centres than there are paediatric cardiac surgical centres. It is, however, something significant, and I wanted to let you know not only that it was happening but also that I am keeping my eyes on it very closely.

First Published in GUCH News Summer 2010