NHS hospital wins right to challenge closure of children's heart surgery unit

The Royal Brompton is one of three London hospitals with a children's heart surgery unit and the only one to face closure. Photograph: Dominic Lipinski/PA Archive/Press Association Ima

The Royal Brompton hospital in London has won permission for a judicial review of what it argues are "fundamentally flawed" NHS plans that threaten to close its children's heart surgery unit.

The hospital stands to lose its unit under proposals to reduce the numbers of hospitals carrying out children's heart surgery from 11 to six or seven. Experts agree that children will be safer if heart surgery is concentrated in fewer, larger units where surgeons are more experienced.

But the proposals put forward by the "Safe and Sustainable" NHS review, run by a joint committee representing all primary care trusts, have outraged the Royal Brompton, which is one of three hospitals in London undertaking this very specialised surgery and the only one earmarked for closure in the capital. Their services would be merged into those of Great Ormond Street and the Evelina children's hospital.

The Royal Brompton and Harefield NHS Foundation Trust has now been granted permission to proceed to a full judicial review later this year by Mr Justice Burnett at the high court. It argues that the process leading to the public consultation (which has just ended) on a number of different closure options was fundamentally flawed.

"This is extremely good news, first and foremost for patients," said Bob Bell, chief executive of the trust. "We have always supported the principle that all babies and children who undergo heart surgery deserve the best possible care, but decisions about the future of such vital services have to be made on the basis of sound, objective evidence and the decision-making process must, of course, be entirely transparent. These conditions were not met by those responsible for this review."

However, the trust did not succeed in getting the reorganisation stopped in its tracks. Mr Justice Burnett said it "is desirable for the joint committee to continue its work of improving paediatric cardiac surgery for the nation". It was with "some hesitation" that he agreed that the Brompton had an arguable case, he said.

The Brompton claims that the decision to reduce London centres from three to two was not based on any evidence, but was an attempt to ensure London shared "the pain of closure" with other units around the country.

The trust also argues that it was not represented on the decision-making body, while the other two London centres were. It says its results are very good and that closure of the heart unit would have a damaging impact on its other services, including adult heart surgery.

Hospital reorganisation plans are invariably hard fought and the Brompton is not the only centre to campaign against the proposed closure of its children's heart surgery unit, but it is the only one to take legal action. Others have sent in mass petitions and MPs from Leeds succeeded in obtaining a debate on the floor of the House of Commons. There have been 70,000 responses to the public consultation exercise, including 20,000 text messages.

Jeremy Glyde, programme director for Safe and Sustainable, said: "The rationale for change is supported by medical experts, professional associations and leading national heart charities. Pooling expertise will help the NHS make further improvements to patient outcomes and deliver a truly excellent service." An independent panel would now look into the Brompton's claim that other services would be damaged if the children's heart unit closed, Glyde said.

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Sabotage inquiry over three hospital deaths

Stepping Hill hospital in Stockport, where a police investigation is under way following the deaths of three patients. Photograph: Dave Thompson/PA

Hospital staff are being questioned by police over three patient deaths after medication was deliberately tampered with, affecting 12 patients on a ward.

Police were called in by Stepping Hill hospital in Stockport after it was discovered insulin had been injected into ampoules of saline solution. It appears that 36 ampoules in a storeroom were affected. On Monday, a nurse noticed that 12 patients on her ward had unexpectedly low blood sugar levels.

Three patients died, including a 44-year-old woman with multiple sclerosis and a 71-year-old man with serious medical conditions. Both were terminally ill. The third person was 84. The specific ward has not been identified.

Greater Manchester police's major incident team is investigating. The South Manchester coroner has been informed and is consulting with police.

Detectives are now trying to find out whether the insulin led to the deaths of the patients. Postmortem examinations are due to be carried out by a Home Office pathologist.

Staff at the hospital alerted police on Tuesday after the discovery of the problem with patients' blood sugar levels.

An internal investigation by hospital bosses found that the saline ampoules had apparently been interfered with.

The ampoules are stored in a central location at the hospital but a small number are also stored on the ward where the affected patients were. All affected patients and their relatives have been informed.

Detective Superintendent Julian Ross, who is leading the inquiry, said: "This investigation is at a very early stage and we don't know what effect, if any, the [contamination] has had to the wellbeing of any patients.

"We have recovered a number of ampoules of solution and are working closely with the hospital to try to get to the bottom of what has happened.

"There is no need for people in the community to be unduly alarmed but I would ask anyone who might have information about what may have happened to get in touch."

In a statement, Stockport NHS Foundation Trust said: "We called in GMP [Greater Manchester police] to investigate after staff found that some saline ampoules were found to be contaminated at the hospital.

"On 11 July, an experienced nurse reported a higher than normal number of patients on her ward with unexplained low blood sugar levels.

"The hospital found that some saline ampoules had been interfered with and, as a result, commenced an immediate investigation. GMP has been asked to assist with the investigation, which is at a very early stage.

Stockport NHS Foundation Trust's chief executive, Dr Chris Burke, said: "We are now in the process of contacting patients and the relatives of those who may have been affected.

"The trust has done an initial check of all ampoules in the hospital and is carrying out a number of additional measures to safeguard patients."

The South Manchester coroner, John Pollard, said: "I am investigating two deaths. I've ordered a Home Office pathologist to carry out postmortem examinations. I am awaiting the results in consultation with the police."

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