Agenda item

This report provides background and context to the potential transfer of congenital heart disease surgical and interventional cardiology services away from Royal Brompton Hospital to appropriate alternative providers (subject to consultation).

Councillor Richardson welcomed guests and speakers for this item which was to receive an update regarding the Royal Brompton.  Dr Richard Grocott-Mason echoed earlier comments about the benefits and power of collaborative work which strengthened and supported the healthcare system.  The work of NHS staff in treating Covid-19 patients at the Brompton was commended with high survival rates for patients on ECMO (extracorporeal membrane oxygenation).  The Brompton was one of only two hospitals which had continued to provide cardiac treatment throughout the pandemic. 

Dr Grocott-Mason outlined why the Trust supported the proposal to relocate services to Guys and St Thomas hospital.  The time taken to invest in, build and develop specialist services such as paediatric congenital heart disease was considerable and invaluable.  It was confirmed that Brompton and Harefield hospitals would not be closed and that the intention was to ensure the continuation of clinical outcomes.  Consultation about Evalina London Children’s Hospital as the new site for services was planned for June 2021 but a new facility was unlikely to be available until 2025 or 2026.  In terms of collaboration the consolidation of services would not affect academic ties with Imperial, but this was an exciting opportunity for two hospitals to come together for the benefit of patients. 

Dr Bob Klaber outlined the views of Imperial College Healthcare NHS Trust.  The clinical needs of the population and access to high quality health services were key factors.  Dr Klaber welcomed the increased collaboration around care pathways and the assurance around academics working together.

Roy Margolis enquired about the benefits of the proposal.  Dr Grocott-Mason reiterated that this would be the unification of services based at Guys and St Thomas’s.  Myocardial infraction services at Brompton would remain and there were currently no plans to downsize the provision. 

Councillor Quigley outlined her personal association with the Brompton and expressed her concern about the potential long-term and adverse impact of residents in north west London travelling to Guys and St Thomas.  The age of the estate was also an issue, despite the many excellent services offered.   Councillor Quigley referred to page 4 of the report and enquired about how consultation and engagement would be undertaken.  Dr Grocott-Mason clarified that where two hospitals trusts joined services this was not required.  There was no plan to move adult services and if this was the case there would be a consultation and equalities impact assessment.  It was confirmed that services would be continued to be provided from Brompton for the next ten years. 

Jim Grealy asked about the value of the real estate and sought clarification about what services would remain at Brompton.  In terms of the estate, Dr Grocott-Mason confirmed that the current pandemic had highlighted the difficulties designing segregated space and managing infection control areas.  Robert Craig explained that the first service that would transfer would be children’s, subject to consultation.  NHS England had already decided that paediatric services should only be provided by a specialist children’s hospital and that linking up services with either Evalina or Ormand Street was at least six years off, and that until then services would remain as they are. Conversations regarding the estate and value were questions to be considered in the future.

Councillor Richardson sought clarification regarding the Imperial proposal which could see services delivered from Hammersmith and St Marys hospitals and so remain in west London.  Dr Klaber responded that this not a “bid” but that Imperial had been asked by NHS England to provide a response.  The key stage of the process was the expected clinical transition board that would emerge and identify the clinical needs of the north west London area.

Councillor Coleman sought clarification about the parameters for consultation and engagement and questioned the delay in the consideration of estate valuation until services were about to be removed.  Dr Grocott-Mason confirmed that where services needed to be moved, then they would be subject to consultation (a legal process run by NHS England) by Public Health England and that the clinical senate board would also be consulted.  There was a rigorous process in place to ensure that there was evidence based clinical reasons for changes in service provision. In terms of engagement, there would be equalities impact assessment and services would be codesigned through patient engagement.

RESOLVED

That the report be noted.