14 July 2011
Bristol children’s heart services now amongst the best
Paediatric cardiac services in Bristol are amongst the best in
the country 10 years after the report of the public inquiry into
children's heart surgery at the Bristol Royal Infirmary between
1984 and 1995 was published. The report was published on 18 July
2001.
"The Kennedy Inquiry was of enormous national significance and
led to wide ranging changes in practice across the NHS,
particularly in the area of clinical governance. All staff involved
in children's heart services have worked extremely hard to deliver
real improvements for children and their families. As chief
executive of University Hospitals NHS Foundation Trust (UH
Bristol), I am very proud that children's heart services at the
Bristol Royal Hospital for Children (BRHC) are now amongst the
best," said chief executive Robert Woolley.
All children's heart surgery moved from the Bristol Royal
Infirmary to the Bristol Royal Hospital for Sick Children in 1995.
Then in 2001 the new Bristol Royal Hospital for Children opened and
all children's heart services have been delivered from this modern
hospital since then.
Dr Jacqueline Cornish, head of division for Women's and
Children's Services, said: "Moving into the new purpose
designed hospital 10 years ago enabled us to deliver care of the
highest quality to local and regional children and to grow our
services. We are now investing nearly £30 million to centralise all
specialist paediatric services for the South West region here at
the Children's Hospital. When this work is completed we will have
new and extended facilities to house the existing and transferring
services from North Bristol, as well as a brand new
state-of-the-art hybrid cardiac catheter lab and other additional
facilities for children's cardiac services."
The paediatric cardiac service now employs three surgeons, seven
cardiology consultants and utilises extensive multi-disciplinary
support services including a 15-bed paediatric general intensive
care unit caring for children from the South West and South Wales.
In 2010/11, a total of 704 procedures were carried out comprising
354 surgical procedures and 350 catheter procedures. These figures
are subject to final validation by the Central Congenital Audit
Database (CCAD).
Results
The servicebased at the BRHC has consistently demonstrated the
quality of its care with outcomes that are amongst the best in the
country. This is demonstrated by the results of the comparative
outcomes assessment for 2000 - 2008 undertaken as part of a recent
review which showed that the Bristol service has the third best
mortality rates when mortality rates are compared between the 11
current surgical centres in England. Mortality figures for 2007 -
2010 show that the Bristol centre had a 1.6% mortality rate for
surgical procedures in the under one year age group and 1% in the
one - 15 year old age group.
"These results are testimony to the dedication of the whole
clinical network, from early and accurate diagnosis to the
necessary teamwork in the theatre and intensive care arenas, as
well as the support following discharge home by our colleagues in
Cardiff and the peripheral hospitals in the South West and South
Wales," said Mr Andrew Parry, lead consultant paediatric cardiac
surgeon, BRHC.
Bristol has a proactive cardiology programme and cardiologists
and cardiac surgeons work together to ensure that the most
appropriate care for the patient is provided.
"Where we can, we will often choose to perform a cardiology
procedure on a patient rather than opt for surgery. Performing an
interventional cardiology procedure rather than open heart surgery
often means that the patient does not need intensive care and can
very often go home within 24 hours," said cardiologist Dr Robin
Martin.
A well-established network
The Bristol paediatric cardiac service works successfully as the
hub surgical centre in a network that extends across the South West
and South Wales, enabling it to care for children from a wide
geographic region, in partnership with their referring
hospitals.
The Bristol team can be contacted 24 hours a day by
clinical staff in regional hospitals and Bristol-based
cardiologists hold clinics in Bath, Barnstable, Cheltenham, Exeter,
Gloucester, Plymouth, Swindon, Taunton, Torbay and Truro.
The team also works closely with consultant paediatric
cardiologists in University Hospital Wales, and, for the last 10
years, both teams have worked successfully in partnership to care
for children from across South Wales. Children from South Wales who
need cardiac surgery, a cardiology intervention or cardiac
intensive care come to Bristol for treatment with the Cardiff
cardiologists providing an in-patient service at University
Hospital Wales and a network of peripheral clinics across South
Wales.
"The Bristol team is also developing a telemedicine service
which we will extend. Using live links with hospitals in Exeter and
Truro, we can work with paediatric staff there to diagnose and
treat patients. This is especially valuable if a patient is
admitted as an emergency. We support local clinicians by providing
a specialist diagnosis which helps us and the referring
paediatricians decide whether and how to transfer a child to
Bristol and what course of treatment to take," said paediatric
cardiologist Dr Andy Tometzki.
Care from the womb into adulthood
The treatment of cardiac conditions often starts with diagnosis
before birth. The Bristol team works closely with the fetal
medicine team at St Michael's Hospital and with other maternity
staff across the South West. Cardiologists, obstetricians and
midwives co-ordinate the care of mothers of unborn babies with
diagnosed heart conditions to ensure the babies are born in the
most appropriate location.
"Once the baby is born, we can treat the child through childhood
and adolescence at the Children's Hospital and then transfer care
at the right time to adult services at the Bristol Heart Institute,
a few hundred metres away. With these services located so close
together we are able to provide continuous care from the womb into
adulthood," said Dr Andy Tometzki.
The future
"Children's heart services in Bristol have gone from strength to
strength. We provide high quality, safe care, that is amongst
the best in the country and we work successfully with colleagues
across South Wales and the South West to meet the challenges
of providing specialist cardiac services to children
across a wide geographic area. In addition we have a very well
developed research programme co-ordinated through the Biomedical
Research Unit. We have a strong future as we await the outcome of
the Safe and Sustainable review of children's congenital heart
services in England," said Dr Jacqueline Cornish.
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