Save Our Surgery (SOS) has been established to challenge the Joint Committee of Primary Care Trust’s (JCPCT) decision to close Leeds children’s heart surgery unit. SOS has announced it has applied to the High Court for permission for Judicial Review.
SOS is disputing the legality of the JCPCT decision to close the paediatric cardiac surgical unit in Leeds, which will leave Yorkshire, Humber and the North Midlands with a poorer children’s heart surgery service.
The JCPCT made the decision to close the Leeds unit following a national review of children’s heart surgery delivery. This means patients across Yorkshire and The Humber will have to travel up to 150 miles to Newcastle, Birmingham or Liverpool for treatment.
SOS’s commencement of the Judicial Review process follows the JCPCT’s rejection of a detailed alternative solution. This proposed a pause in the implementation of the JCPCT decision for north-eastern England until 2014, to review the decision and its consequences, and understand where patients would choose to be treated.
Save Our Surgery’s concerns regarding the process and resulting JCPCT decision are focussed on three key areas:
Transparency in the JCPCT’s process
- The lack of transparency on the part of the JCPCT has led to significant concerns about how hospitals were scored by a specialist panel and whether there may be major flaws in the subsequent decision making process.
- The decision to close Leeds was based on a set of judgements made by a specialist panel that graded each hospital independently, without ever intending to compare the quality of the surgery or the facilities in Newcastle and Leeds. This means that the score for the two centres was being used for a different purpose than the one which for which it was intended.
- The JCPCT decided not to look at the breakdown of the scores because it was advised that if it did it would be vulnerable to Judicial Review.
- The JCPCT then made the decision that, if they had not looked at the sub-scores, no-one else should either, partly because they did not think anyone locally would be competent to comment on them and partly because they were not relevant to the decision they were taking.
- Despite repeated requests from the Leeds children’s surgery unit, and the Joint Health Overview & Scrutiny Committee, the group of Yorkshire councils with a statutory responsibility for scrutinising this decision, the JCPCT refused to provide details of the underlying data behind this scoring during the consultation process.
- This made it impossible to understand the analysis or point out errors until after the decision had been made.
- Subsequent requests to revisit this, once the underlying data had been examined, were rejected on the basis that the decision had already been made.
Quality of Service
- Once the scores were seen, it was recognised that they included major errors when used to compare the relative attributes of the different heart units
- Leeds also has significant advantages in providing proper co-location of all services these children may need on a single site.
- Leeds has a much larger unit, with more facilities and staff. The JCPCT proposal would involve trying to fit a larger centre into a smaller one.
- Leeds is at the heart of a fully developed multi-disciplinary clinical network which was voted the best in the country by specialists nationally.
- Because the JCPCT never saw the breakdown of the scores, it did not realise that its advisory panel had reached a set of judgements that it could not defend when used for the purpose of comparing different centres.
Access to services for people in the North
- The decision to close the Leeds facility leaves the entire Yorkshire and Humber region with no centrally located children’s heart surgery unit.
- This means that children and their families will have to travel over 150 miles – at least a 2.5 hour journey – when they may be in critical condition.
- Over 600,000 members of the public in Yorkshire & the Humber expressed concern about this during the public consultation process in a petition but their views were counted as one response as they had not been submitted through a complex document or text service.
- The Leeds paediatric cardiac service has over 10,000 patient visits per year and the quality of the service rendered to all of them will be undermined.
- The JCPCT was advised that parents from many parts of Yorkshire would not choose to travel to Newcastle. It decided to disregard this on the basis that the referring specialists would be able to persuade them to travel. This makes a mockery of patient choice.
Sharon Cheng from Save Our Surgery, said:
It’s with great regret and reluctance that Save Our Surgery has decided to lodge this application for legal action against the decision to close the Leeds children’s heart surgery unit. Quite simply, we feel we’ve been left with no alternative after all other options put forward were rejected outright by the senior NHS officials responsible.
Fundamentally, this action is about making sure that children across the country have proper access to vital, life-saving services. We remain hopeful that common sense and democracy will prevail, and that Health Ministers will use their powers to take up our proposed compromise solution, which offers a safer and more sustainable future for children’s heart surgery in the North than that advanced by the JCPCT.
Kevin Watterson, Congenital Heart Surgeon and Save our Surgery Campaigner, said:
As we have made very clear, repeatedly, since the decision was made, we have grave concerns about how this decision has been reached and the impact it will have on patients and their families.
When you consider the location of patients in the North and their proximity to Leeds – a surgical unit previously classed as ‘excellent’ in terms of safety by Sir Ian Kennedy’s panel of experts – and how far some patients will now have to travel to receive urgent care, you can only conclude that the NHS core principles of patient safety, experience and outcomes have not been the central factors in this decision. Clearly, this action is not about a narrow technicality. It’s about quality of service, the entire review process and how these life-altering outcomes were reached.
We are fighting to keep children safe and we believe that challenging the decision is the only way of doing that at this stage.
The SOS application for permission to seek a Judicial Review follows widespread public outcry since the decision was made on July 4th 2012. A High Court judge will now review the legal arguments and determine whether there are merits in the case to decide if the legal challenge can take place.