British Congenital Cardiac Association

Annual General MeetingBirmingham

Nov 19th 2008

Reconfiguration Poll

BRITISH CONGENITAL CARDIAC ASSOCIATION

BRITISH CONGENITAL CARDIAC ASSOCIATION

• Discussed extensively over the last 10 years • DoH view - desirable and probably

inevitable. • Essential BCCA represents members views in

consultation process

Reconfiguration of Congenital Heart Services in England

BRITISH CONGENITAL CARDIAC ASSOCIATION

• Reconfiguration poll July 08

Reconfiguration of Congenital Heart Services in England

BRITISH CONGENITAL CARDIAC ASSOCIATION

BCCA and Reconfiguration of Congenital Heart Services in England July 2008 Dear Colleagues, The issue of reconfiguration of Congenital Heart Services in the United Kingdom has been discussed extensively over the last 10 years. It appears that in the Department of Health, reconfiguration is viewed as desirable and probably inevitable. If this is the case then it is essential that the BCCA are involved in the consultation process. The aim of this letter is to solicit views from all members of the BCCA regarding the reconfiguration of Congenital Heart Services in England. In recent years, the BCCA have followed the reconfiguration policy discussed in previous BCCA business meetings and endorsed by the Monro report (Paediatric and Congenital Cardiac Services Review Group 2002). In brief, this proposes a planned service reconfiguration and a move to a reduced number of appropriately funded and staffed Congenital Heart Centres in the United Kingdom. The PCCSG report in 2002 recommended a peer group review of the recommendations within 5 years. In June 2006, a meeting was hosted by Professors Rog er Boyle and Sheila Shribman. This meeting, attended by representatives of all UK units, supported the policy of planned reconfiguration and the minutes concluded; “.. we should aim for large centres of excellence with a minimum of five surgeons and eight cardiologists per centre. A transitional stage would be to have joint alliances of current centres.” At the November 2007 BCCA Business meeting, it became clear that a number of BCCA members dissented from this policy. Moreover, it is apparent that the implications of the June 2006 meeting were not discussed widely outside of the immediate attendees. The aim of this letter is for the BCCA Council to obtain a view from the BCCA membership on their views on service reconfiguration. The attached request for views from you will give the BCCA a mandate to speak with authority on behalf of BCCA members . Please use the accompanying form to record your specific views and concerns regarding the reconfiguration process. With best wishes on behalf of the BCCA Council, Mr WJ Brawn Dr AG Stuart President BCCA Honorary Secretary BCCA

Do you think reconfiguration for congenital heart services in England is required? Y/N

If yes, how do you think this process should take place?If no, give reasons.

BRITISH CONGENITAL CARDIAC ASSOCIATION

Reconfiguration Poll Results

N = 69

(>300 sent)

BRITISH CONGENITAL CARDIAC ASSOCIATION

Reconfiguration Poll Results

Reconfiguration Comments

• Current situation not sustainable !

Reconfiguration Comments

• Current situation not sustainable !• Congenital Heart Centres ( not just children)

– Minimum 5 surgeons 600 ops. (=EWT) – ? 8-10 optimum number – Consider accessibility/ population density

Reconfiguration Comments

• Current situation not sustainable !• Congenital Heart Centres ( not just children)

– Minimum 5 surgeons 600 ops. (=EWT) – ? 8-10 optimum number – Consider accessibility/ population density

• Patients will travel for “best “ care Staff may not move....

Reconfiguration Comments

• Current situation not sustainable !• Congenital Heart Centres ( not just children)

– Minimum 5 surgeons 600 ops. (=EWT) – ? 8-10 optimum number – Consider accessibility/ population density

• Patients will travel for “best “ care Staff may not move....

• Needs major capital investment– Parking/helicopter– 24hr cover for all subspecialties– Must be properly funded and staffed

Reconfiguration CommentsBut .....

• Is it investment rather than reconfiguration• Big units have problems ......communication/parking / .....• Knock on effects for other paed specialties• Many small units provide superb service!• Consider collaboration rather than closure....( rota, procedures etc)• Local clinicians should decide local solution

A few comments......

Anarchy if

goes

ahead....

Chaos if nothing done ....

There is a BCCA majority consensus for reconfiguration process to go forward provided there is adequate planning, investment and local support.