This world renowned heart and lung hospital is a few minutes drive from Ruislip. Its reputation for clinical excellence is second to none, despite its old buildings.
There are plans to rebuild the hospital on its present site, but that lies a long way ahead. It is part of the Royal Brompton and Harefield NHS Foundation Trust and we obtain regular reports on that Trust’s Board Meetings held in public
Note: The notes below are gleaned from the Board papers. This report is supplementary to Mike Gordon’s report of the verbal proceedings - he represented the Community Voice at that meeting.
The DH target for 2012-13 was maximum one case of hospital acquired MRSA bacteraemia, and the Trust had just one case in the year – but 123 new MRSA cases were identified on admission plus 27 identified for out-patients. The Trust aims to have a valid MRSA screening test result for clinicians prior to a patient undergoing any invasive procedure.
Some people carry clostridium difficile in their gastrointestinal tract quite harmlessly but others suffer diarrhoea, some severe intestinal damage. The Trust reported 21 cases in 2012-13, failing its target of maximum seven cases – a target that it claims is unreasonable for the service it provides, and which it is still disputing with the DH. Also it has one of the lowest rates in London and the UK.
Other NHS targets:
The Trust met most targets but failed the target for treatment to start within 18 weeks from referral by a GP. It ended the year with a financial risk rating of 3, as required.
As a result of structural changes within the national health system, around 85% of the Trust’s income will be deemed specialist and will be sourced via NHS England.
Specialist heart services:
Foetal cardiologists can perform scans on 12 weeks old babies, when the heart valve is just over a millimetre in size. Clinicians also regularly treat patients >90 years old.
Despite the uncertainties of the national review of children’s heart surgery, the Trust has continued to invest in children’s services. A new 4-bed sleep and ventilation unit for children has been opened providing state-of-the-art care for children with sleep related disorders. The Trust is undertaking paediatric sleep medicine research and developing collaborative programmes with other leading centres in Chicago, Toronto and Brisbane.
During the year the Trust explored the possibility of relocating the Royal Brompton Hospital to another site, but in March 2013 it agreed that the redevelopment of both Royal Brompton and Harefield Hospitals will be in situ, subject to planning and financial factors.
Significant investment in Harefield Hospital in 2012-13 increased the Acorn Ward capacity by 18 beds, and created the Cherry Tree Day-Case Unit with 16 beds. Also, a fourth replacement cardiac catheter laboratory was opened in June 2012.
With over 20 transplants in 2012-13, transplant services more than doubled in comparison with last year, and clinical outcomes improved. A new transport system pumps blood around the heart outside the body during transport, which means that organs can be collected from a wider geographical area and they arrive in better condition than a non-beating heart transported on ice.
A new consultant post, funded by the Higher Education Funding Council, complements the Harefield Respiratory team and takes forwards the development of Respiratory services at Harefield.
The recent decision by PCTs to discontinue funding of paediatric heart surgery at the Royal Brompton Hospital will not be implemented before April 2014. An international panel under Professor Hutton has been set up to provide independent advice on the knock on effects of that decision on the trust’s other services, particularly with respect to paediatric respiratory services.
The Trust will decide by 1st January 2013 whether to stay on the Chelsea site or to relocate the Royal Brompton Hospital to another site.
The Trust remains committed to services in Harefield Hospital
The Royal Brompton & Harefield Trust responded with a statement of great regret, but reassured patients that the decision would not be implemented immediately. The Trust is considering how it will now move forward and how it will minimise the impact of the decision on other services.
- Judicial Review:
The Trust's priorities for 2012-13 include
- Improving advice and information given to patients about their medication
- Improving communication about tests and treatments
- A focus on outcomes from treatment
The Joint Committee of Primary Care Trusts who produced the Safe and Sustainable recommendations for Paediatric Cardiac Surgery have succeeded in their request for an appeal in respect of the Judicial Review Judgment. Their appeal will be held on the 19th, 20th and 21st March 2012. This is disappointing and the hearing is a lot earlier than anticipated.
The Trust continues to consider sites for the relocation of the Royal Brompton Hospital and it currently favours a number of sites in the White City area of London because of their adjacency to the Imperial College NHS Foundation Trust with whom they anticipate closer co-operation in the future.
The review into Services Configuration in North West London continues and it is anticipated that public consultation on the recommendations is anticipated to commence in June 2012.This seems very optimistic.
Imperial College have invited the Trust to nominate a representative to join their Court. This is seen as a considerable compliment to the Trust and Sir Robert Finch has agreed to be the nominee.
No further information is available on the possibility of Project Diamond funding in the current financial year.
There has been no case of MRSA in the current year and still only 10 cases of Clostridium Difficile. This remains a truly excellent performance.
The Trust is still forecasting an end of year surplus of £2,980m. Any Project Diamond Funding would obviously improve this already good result.
The next meeting of the Trust is on Wednesday 28th March at 10.30 in the Concert Hall at Harefield Hospital.
Also, the current verdict only opens the way to fresh review and consultation, since Judicial Review applies only to the process and has no impact on the merits of otherwise of the recommendations. So, we can rejoice that a battle has been won but, sadly, the war is likely to continue and for those who want the Royal Brompton to continue to provide its excellent children's heart surgery, success is not yet achieved.
The Trust’s November Board Meeting focused on the various cardiothoracic reviews that are currently taking place in London and nationally, all of which could impact significantly on the Trust. These include:-
- Paediatric Cardiac Surgery – the decision of the Judicial Review was still awaited.
- National Review of Cardiothoracic Transplant Services.
- London Review of Cardiac Services.
- National Review of Congenital Heart Disease.
The Trust has been awarded Respiratory and Cardiovascular Biomedical Research Unit status for the period 2012-2017 which brings an income of £19.5m over the five year period. This compares with the £9.1m awarded in 2008, so is excellent news.
The Board is actively considering relocating the Brompton Campus in order to generate cash for the redevelopment of the Royal Brompton and Harefield Hospitals. It is looking at a number of sites including four in North West London.