High Court quoshes NHS decison on designated paediatric cardiac surgery units

28 March 2013

heartFollowing Save Our Surgery’s High Court win against the Joint Committee of Primary Care Trusts (JCPCT), the judge has quashed the JCPCT decision of 4 July 2012 relating to the choice of children’s heart surgery units and its assessment of quality within those units.

This decision from High Court judge, the Hon Mrs Justice Nicola Davies, follows her 7th March ruling in favour of Save Our Surgery (SOS). She found that the consultation and decision making process which underpinned the JCPCT’s reconfiguration of paediatric cardiac surgery services across England and Wales was flawed, and the assessment of Quality of Services – meant to be at the heart of the reconfiguration decision – was unfair and unlawful.

Based on the outcome of the hearing, the National Commissioning Board (the new body replacing the JCPCT) must now re-consider the elements identified by the judge and ask questions about the quality scores and how they were arrived at, including issues of travel and access. The judge has asked that they then report back on their findings and decide upon which centres are to be designated on those new grounds

The court hearing allowed all participants in the High Court case to put forward their arguments as to what to do next given her view that the consultation was unlawful. Save Our Surgery (SOS) suggested:

  • The only appropriate outcome of the ruling is for the High Court to quash the July 4th decision regarding which hospitals retain children’s heart surgery services and which will not, including the removal of services from Leeds General Infirmary.


  • That JCPCT media statements issued following the March 7th ruling mischaracterised the judge’s ruling, claiming that it was “focused on a narrow technicality”; in fact, the judge found in SOS’s favour in every aspect of the judicial review case which challenged the way that Quality of service was determined for each hospital involved. The judge strongly supported this point in Court today.


SOS has not specified what further steps are necessary beyond the quashing of the 4th July decision, but has asked that the JCPCT pays due consideration to the High Court’s ruling and its implications in defining how best to move forward. Factors that should be considered include:

  • The reliability of data used to assess the various hospitals’ capabilities in the original review process.


  • The weighting attached to Quality in the reconfiguration, and whether there are in fact material differences in quality between closely ranked centres and, if so, what those differences are.


  • The importance of other assessment factors when looking at where to locate paediatric cardiac services, including travel and access for patients, co-location of vital services, strength of cardiac care network and financial viability.


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Sharon Cheng of Save Our Surgery says:

We are extremely pleased and relieved that the unfair and flawed decision to stop surgery in Yorkshire and the Humber has been quashed. Today’s judgement vindicates our decision to pursue this case through the courts. We brought this case on behalf of the families and patients of our region whose genuine concerns about the review had been consistently ignored by the NHS.

The first line of the NHS constitution states ‘the NHS belongs to the people’. We now call on the decision makers to reflect that by engaging with us to ensure the final outcome is the correct one for children across the country.

The judge has asked that the IRP continues its independent review and report back to the Secretary of State in line with the existing timeline of the end of April.

The JCPCT was not granted leave to appeal, with the judge telling them that there were no legal grounds.

Sir Neil McKay CB, Chair of the Joint Committee of Primary Care Trusts, said:

Following today’s ruling, we are strongly considering our grounds for appeal. The NHS remains as determined as ever to reconfigure children’s heart services. The NHS will of course study the ruling carefully and its implications. The Judge was very clear that she was not advocating a return to the start of the review process. I am pleased that the Judge has upheld our decisions in relation to the quality standards and the model of care.

We will give due consideration to the judgment and will advise people of the next steps in the process at the beginning of April. We will aim to reach a final decision in June 2013, pending the outcome of the separate IRP process.

The Court and all the hospitals involved recognise the need for the NHS to continue in our important mission to improve services for children with congenital heart disease and the NHS remains absolutely committed to ensuring that services are safe and sustainable in the future. The case for the reconfiguration of children’s heart services remains strong and there continues to be a rare consensus amongst medical royal colleges, professional associations, NHS staff and national parent groups that the NHS needs fewer larger surgical centres and new national quality standards to improve outcomes for children. Safe and Sustainable will continue.

The expert view remains that the longer vested interests delay this process, the greater the risk of safety concerns manifesting in the units. I never forget that the purpose of our work is saving lives and improving quality of life for children, and on behalf of the NHS I want to reassure families, patients and clinicians that we remain as determined as ever to reconfigure services for children with congenital heart disease in the interests of better outcomes and a more safe and sustainable service for children and their families.

The decision we took in July last year will help save children’s lives, reduce co-morbidities and ensure ongoing care is provided closer to many families’ homes.

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