Reconfiguring children ’ s congenital heart services in England
22
Reconfiguring children’s congenital heart services in England 1 Public Health’s role in major service reconfiguration Matthew Day North of England Specialised Commissioning Group (Feb 2011-Feb 2012) School of Public Health Regional Conference 2012
description
Reconfiguring children ’ s congenital heart services in England. Public Health ’ s role in major service reconfiguration. Matthew Day North of England Specialised Commissioning Group (Feb 2011-Feb 2012) School of Public Health Regional Conference 2012. Congenital Heart Defects. - PowerPoint PPT Presentation
Transcript of Reconfiguring children ’ s congenital heart services in England
Reconfiguring children’s congenital heart services in
England
1
Public Health’s role in major service reconfiguration
Matthew DayNorth of England Specialised Commissioning Group
(Feb 2011-Feb 2012)
School of Public Health Regional Conference 2012
Congenital Heart Defects Defect in structure of the
heart present at birth 8/1000 prevalence Surgery rare Approx 3’600 operations
per year
Slides on the Safe and Sustainable Review of Paediatric Congenital
Cardiac Services in England, October 2010
2
Background 2001 : The Bristol Royal Infirmary Inquiry
Report (the Kennedy Report) recommended the need for Children to have heart surgery performed in fewer specialist centres.
March 2011 the NHS led review ‘Safe and Sustainable’ consultation document proposing options for the future delivery
Proposal to reduce the number of centres which currently performed these complex operations from ten centres, to six or seven.
3
3600 Operations
>30 surgeons specialising in England
10 centres doing surgery
4
Magic numbers
5
6
Option A
Option A Seven surgical centres at: • Freeman Hospital, Newcastle • Alder Hey Children’s Hospital,
Liverpool • Glenfield Hospital, Leicester• Birmingham Children's Hospital • Bristol Royal Hospital for Children• 2 centres in London
Slides on the Safe and Sustainable Review of Children’s Congenital Heart Services in England, March 2011
7
Option B
Option B Seven surgical centres at: • Freeman Hospital, Newcastle • Alder Hey Children’s Hospital,• Liverpool • Birmingham Children's
Hospital• Bristol Royal Hospital for
Children• Southampton General
Hospital• 2 centres in London
Slides on the Safe and Sustainable Review of Children’s Congenital Heart Services in England, March 2011
8
Option C
Option CSix surgical centres at:• Freeman Hospital, Newcastle • Alder Hey Children’s Hospital,
Liverpool• Birmingham Children's Hospital • Bristol Royal Hospital for Children• 2 centres in London
Slides on the Safe and Sustainable Review of Children’s Congenital Heart Services in England, March 2011
9
Option D
Option D Six surgical centres at:• Leeds General Infirmary • Alder Hey Children’s Hospital,
Liverpool • Birmingham Children's
Hospital• Bristol Royal Hospital for
Children • 2 centres in London
Slides on the Safe and Sustainable Review of Children’s Congenital Heart Services in England, March 2011
The politics!
10
Public Health Role!
11
Public Health Role: The Science
Regional Health Impact Assessment (HIA) of the proposed consultation options
Regional ‘information group’ established
Health Impact Assesment
Epidemiology Patient flows Network configuration Travel and access Patient experience Fetal cardiology Financial Staffing
Slides on the Safe and Sustainable Review of Paediatric Congenital
Cardiac Services in England, October 2010
13
Epidemiology: Surgical procedure rates
14
PCT Total Paediatric Rate/10,000 pop
Bradford and Airedale 51 4.73
Leeds 52 4.17
North East Lincolnshire 11 3.88
Wakefield District 21 3.77
Sheffield 31 3.55
Barnsley 13 3.28
East Riding of Yorkshire 17 3.22
Calderdale 11 2.92
Doncaster 15 2.90
Kirklees 22 2.81
Rotherham 11 2.41
Hull 10 2.28
North Lincolnshire 6 2.18
North Yorkshire and York 24 1.92PCTs Outside Region 21 -
Total 316 3.5
Table 1 Shows surgical procedures performed at LTHT by age-group and PCT 2009/10.Knowledge of
available data+
Building ‘Trust’ trust+
Really basic number crunching
Epidemiology / Network configuration: Multiple health needs
Knowledge of available data +
clinical network advice +
analytical support+
Complexity to ‘essentials’15
75% patients with multiple health
needs
> 25% Respiratory related
Travel and access / patient experience Patient flows
16
Understanding evidence / pathways
+clinical network
advice+
narrative
Patient / Family Experience
17Source: Interim Health Impact Assessment Draft Appendices - Bradford Event Feedback. Available at: http://www.specialisedservices.nhs.uk/library/30/Health_Impact_Assessment_Interim_Report_Draft_Appendices.pdf
“Some {surgical} centres may not provide services that are culturally specific to the current community.... If communities aren’t able to access culturally sensitive services the quality of care may suffer”
Y&H HIA ‘science’ Influence Regional Commissioner and Provider
CXs Presenting and representing NHS at
Regional Joint OSC Providers National Safe and Sustainable Team Joint Committee of PCTs (decision
making body) Circulated nationally as exemplar Advised PWC / MM for National HIA /
Patient Flow work
18
Public Health (dark) ‘Arts’
RelationshipsCommunication
Written – complexity to essentials
Non-verbal
Conflict
19
Lessons for Public Health role in major service reconfigurations
Professional leadershipTechnically astuteComplexities to essentialsPH ‘Communicators’PH as ‘Honest brokers’
20
Safe and sustainable Timeline Largest Ever NHS
Consultation - >75,000 responses
Y&H petition > 600,000 signatures
Royal Bromptom Vs JCPCT (Sept 2011). Consultation unlawful
JCPCT Appeal - verdict overturned. Consultation lawful.
21
The decision
“The 4th of July will be a milestone for the future of children’s congenital heart
services” Sir Neil McKay, Chair JCPCT
More options now on the table…..
22
