Concerns Raised Over Paediatric Cardiac Surgical Mortality Rate at Leeds Teaching Hospitals NHS Trust

Leeds Teaching Hospitals NHS Trust, one of the largest in the North of England, has been facing concerns over a reported increase in the mortality rate of children after having surgery. The issues reportedly stem from a combination of factors, including an individual clinician's performance, waiting lists, patient flow, and team dynamics within the multi-disciplinary team. An independent review commissioned by the Trust highlighted significant concerns, including a worrying deterioration in surgery outcomes, a rise in serious complications, and a shortage of beds on the paediatric intensive care unit (PICU). The review also noted that the senior surgeon on the cardiac unit is due to retire, but no successor has been appointed, exacerbating capacity issues.

Key Takeaways:

• The Trust has reported an increased paediatric cardiac surgical mortality rate, with surgery outcomes since April 2023 showing a significant deterioration, with the risk-adjusted mortality rate running around three times the national average.
• The number of surgeries where serious complications took place has risen, with a shortage of beds on the PICU, resulting in some surgeries being cancelled on the day due to lack of availability.
• An individual clinician's performance has been questioned, with six cases being investigated, including two deaths.
• The surgeon in question has had their practice "restricted," but this has not affected waiting lists.
• The Trust's senior surgeon on the cardiac unit is due to retire, but no successor has been appointed, exacerbating capacity issues.
• The review highlighted the importance of recruiting more PICU nurses to enable the existing PICU bed base to be fully operationalized within the next 12 months.
• The Trust's Chief Medical Officer, Dr Magnus Harrison, has apologized for the substandard care in four children's cases and has emphasized the swift action taken by the Trust to address the concerns raised.

Statistics:

• The risk-adjusted mortality rate for paediatric cardiac surgery at Leeds Teaching Hospitals NHS Trust is around three times the national average since April 2023.
• The number of surgeries where serious complications took place has increased since April 2023.
• The shortage of beds on the PICU has resulted in some surgeries being cancelled on the day due to lack of availability.
• 18 beds are available on the paediatric intensive care unit (PICU).

Sources:

• Leeds Teaching Hospitals NHS Trust papers
• Reports from the independent review
• Quotes from Dr Magnus Harrison, Chief Medical Officer for Leeds Teaching Hospitals NHS Trust