At one hospital, death rates for one type of operation were ten times those elsewhere.
Research found that over eight years, units at Guy’s and St Thomas’ Trust, Leeds General Infirmary and Glenfield Hospital in Leicester all had more “excess deaths” than at the John Radcliffe Hospital, in Oxford, where surgery was stopped in February amid safety concerns.
Now, NHS authorities are to announce that an expert team is to examine the deaths of babies and children who underwent four types of heart operations at the hospitals in Leicester, London and Leeds, during specific periods of heightened mortality between 2000 and 2009.
The investigation will look at deaths in Leeds between 2003 and 2006, following a procedure to repair Tetralogy of Fallot, the most common congenital heart problem.
In total, six of 47 children who underwent the operation at the Leeds hospital died during the three years. During the same time, just seven of more than 550 children who had the procedure at all 10 other units died.
A national review, which had been due next month to recommend the closure of some of England’s 11 units in order to improve safety has been put on hold until the investigation reports.
Documents seen by The Sunday Telegraph disclose that an independent panel assesssing all the units has demanded the probe.
A report for the NHS Safe and Sustainable programme, dated 28 September, and marked confidential, says an expert team will now be asked “to establish the reasons for the higher than expected mortality that was reported” at the three centres.
Incredibly, until now, the national review had not taken any account either of published data comparing death rates for specific operations, or recent unpublished analysis – disclosed by The Sunday Telegraph in September – comparing the units’ overall mortality rates.
The analysis, by Professor David Spiegelhalter, who led the statistics team at the Bristol Inquiry into baby deaths in the 1980s and 1990s, had identified “excess deaths” at four units.
His findings were submitted into an inquiry into a spate of deaths at the Radcliffe, which was published in July, but kept secret until this newspaper obtained them under Freedom of Information disclosures.
Prof Spiegelhalter’s report compared the number of deaths at each unit, with the number which would have been expected for operations performed between 2000 and 2008.
It found 24 “excess deaths” at Guys, 23 such deaths in Leicester, 20 in Leeds and 9 in Oxford over the period.
Overall, the highest death rate was at Leicester, with 65 per cent deaths above the average, followed by the Radcliffe, with 50 per cent more, Leeds with 43 per cent more and Guys with 29 per cent.
On Friday, NHS Safe and Sustainable, the programme to reorganise the hospitals providing heart surgery, said the review would not recommend any options which would allow the Radcliffe to provide surgery in future.
The hospital came worst in a ranking of the 11 units carried out by the review’s independent panel, led by Sir Ian Kennedy, former chairman of the 2001 Bristol Inquiry into baby deaths.
The same process is understood to have named the units at Guy’s and St Thomas’, Southampton General Hospital, Great Ormond Street Hospital, Birmingham Children’s Hospital and Brompton Hospital in London as the best units to remain and expand.
The units were rated against standards such as the number of operations they performed, the size of their teams, and the quality of leadership. The Radcliffe is understood to have performed poorly on these three measures.
But death rates were not examined in the review.
Findings from the investigation into Guy’s and St Thomas’, Leeds and Leicester will be reported to the national review by December, when it will be decided whether or not to change the rankings, which will determine each unit’s chance of survival.
Leeds Teaching Hospitals Trust, which runs Leeds General Infirmary, said its service has some of the best results in the country, but that concerns with one operation had been identified in 2005.
Changes were made to concentrate expertise, and from 2007 on its results for repair of Tetralogy of Fallot were in line with the rest of other centres, the trust said.
A spokesman for Guy’s and St Thomas’ said the hospital would co operate fully with the review, and was fully supportive of close scrutiny of data. University Hospitals of Leicester Trust, which runs Glenfield Hospital, made no comment.
A spokesman for the NHS Safe and Sustainable programme said there was no evidence to suggest any immediate safety concerns about units which are currently operating.
Telegraph UK