Safe & Sustainable Review

Why should you be worried?
If Southampton is closed, all children from across the south coast, Isle of Wight and the Channel Islands will be sent either to London or Bristol. Southampton is a highly successful centre and is rated the 2nd best performing unit in the country. Not only are the surgical team outstanding, but there is also parent accommodation available, on site at the hospital and in houses close by to the hospital.

In addition, if the cardiac unit is removed from Southampton, it will impact on the rest of the children's services. Half of the PICU beds could be closed, along with the retrievals unit (ambulance) that picks up very sick children from their local hospital and brings them to Southampton.

It is important that everyone acts now! The consultation process closes at the end of June.


My child doesn't have a heart problem?
Heart problems may be detected at birth or may lie undetected for several years. Occasionally a virus may lead to a heart condition. In many cases, time is critical. The longer the wait for treatment, the worse the outcome may be.
In addition, if a child is taken critically ill, they may need specialised treatment in PICU.  For example, contracting meningitis or a road traffic accident.

If the cardiac unit is closed, beds in PICU will in turn be closed. Therefore, other (non-cardiac) children will also face being treated in other hospitals.


I live in Portsmouth, why should I worry?
Although many hospitals have PICU care, Southampton is rated 2nd best performing unit in the country. It also is able to offer specialist care that other PICUs are not able to offer.
Children from Brighton, Chichester, Portsmouth, Isle of Wight, Channel Islands, Dorset, Wiltshire, Berkshire and Surrey all come for treatment at Southampton.
Children from Oxford are already being transfered to Southampton since the paediatric cardiac unit at John Radcliffe Hospital closed last year. Since then, Southampton's cardiac unit has expanded to appoint an additional 4th surgeon.


Why shouldn't I want my child transferred to Bristol or London?
In an independent assessment of children's heart surgery in England, Bristol was rated 6th. One of the London hospitals (Evelina) was rated top in the study. However, consider that a lengthy stay in London will become expensive.
Evelina do make provision for families. There are 18 family rooms in Ronald McDonald houses, but these are a bus ride away from the hospital. Travel to Southampton is easy and there is plentiful accommodation available.
Unless you live close to the centre, it may mean splitting the family for a considerable time. This may add additional stress and worry to an already difficult situation.

Statement from Dr Iain Macintosh, Director PICU, April 2011
“Southampton PICU is a 13 bedded children's intensive care that provides the full ranges of services to subspecialties and retrieves children from as far afield as the Isle of Wight, the Channel Islands and Plymouth. Thirty nine percent of our admissions and 44% of our bed days are used by cardiac patients.

If we lost cardiac surgery these patients would need to go somewhere else and 40% of our beds would close, leaving 7-8 beds. This would mean losing the staff that support these beds. We would then be below the critical mass of resource that we need to run a proper retrieval service. We would lose our coveted training status and therefore would not attract quality middle grade doctors. More patients from this region would need to wait to be transferred by Bristol or London teams or would need to be transported out of region to these centres.

As you are aware a significant part of our resource, from the ambulance that we use for retrieval, to the equipment on the unit and even to the support of a psychologist has been purchased with charity support. Many of the parents most actively involved have children with cardiac disease and although I am sure many would remain loyal, there is bound to be some impact. Some would wish to raise funds for the hospitals that took over their care and that is understandable.

Quality is dependent on resource but it is not just about that. Southampton PICU has been consistently a high performing unit, with a very efficient use of our beds and good outcomes. We admitted 940 patients in the year 2010-2011, absorbing all the additional Oxford work that we were asked to do, with only a marginal increase in funding. Our standardised mortality rate has been one of the lowest in the country for several years and the lowest of all the units in this assessment. Delivering intensive care to complex cardiac surgical patients day in and day out improves the skills of everyone involved, to the benefit of non-cardiac patients as well.

In summary there will be an immediate impact as our capacity to perform certain tasks, particularly retrieval, diminishes. There will also be the less predictable and more insidious effect of dismantling a highly performing unit in the hope that what was removed, does not turn out to be vital to its function.”