The Royal Brompton & Harefield Hospital NHS Foundation Trust Royal Brompton Hospital Congenital Heart Disease Network 2018/19 Annual Report Authors: Dr Nitha Naqvi Dr Leonie Wong Lawrence Mack Simon Boote Approved by: Congenital Heart Disease Working Group Ratification Committee: Congenital Heart Disease Network Board Date Ratified: 29/04/2019 Chairman: Dr Angela Tillett Implemented by: For reference only Issue Date: April 2019 Version: 001 Review Date: March 2020 Review interval: 12 Months Issued: April 2019 Version: 001 Page | 1 Link - Contents 1 Contents Page 1 Contents Page .......................................................................................................................................... 2 2 A message from our Clinical Director ................................................................................................... 4 3 RBH-CHD Network Strategic Vision Statement .................................................................................. 5 4 Summary of Achievements Against our Work Plan – 2018/19 ......................................................... 5 5 Research ................................................................................................................................................... 6 5.1 Grants Awarded ................................................................................................................................ 7 5.2 Research Programmes Peer Reviewed Publications ................................................................. 7 5.3 Research Strategy ............................................................................................................................ 7 6 Education .................................................................................................................................................. 8 7 Summary of Challenges.......................................................................................................................... 8 8 Quality & Safety........................................................................................................................................ 9 8.1 Incidents ............................................................................................................................................. 9 8.2 Complaints ....................................................................................................................................... 11 8.3 Friends & Family Test .................................................................................................................... 12 8.4 PICU Feedback ............................................................................................................................... 13 8.5 Areas of Improvement ................................................................................................................... 14 8.6 Clinical Outcomes ........................................................................................................................... 15 8.7 Fetal Outcomes ............................................................................................................................... 15 8.8 Internal Audit ................................................................................................................................... 16 8.9 Network Presented Audit ............................................................................................................... 17 8.10 National Audit .................................................................................................................................. 17 8.11 Interventions Volumes (excl. diagnostics) – up to 31/03/2019 ................................................ 17 8.12 Surgical Volumes – up to 31/03/2019 ......................................................................................... 18 8.12.1 CHD Surgical Activity.............................................................................................................. 18 8.13 Cancellations ................................................................................................................................... 18 8.13.1 CHD Surgical Cancellations .................................................................................................. 19 8.13.2 CHD Interventional Cancellations ......................................................................................... 19 9 RBH 2018 / 19 Multidisciplinary Performance – 01/04/2018 – 31/03/2019 .................................. 20 9.1 Joint Cardiac Conference (JCC) MDT Meeting Performance Against ToRs ........................ 20 9.2 Adult CHD MDT Meeting Performance Against ToRs .............................................................. 20 Issued: April 2019 Version: 001 Page | 2 Link - Contents 10 Appendix 1 – Strategic Vision Summary ........................................................................................ 21 11 Appendix 2 – Courses from 01/04/2018 – 31/03/2019 ................................................................ 22 12 Appendix 3 – Congenital Heart Summary Outcomes (most current reported data) ................ 25 Issued: April 2019 Version: 001 Page | 3 Link - Contents 2 A message from our Clinical Director Welcome to the Annual Report for the Royal Brompton Hospital CHD Network 2018 / 2019. I am delighted to be introducing our first annual report. This is a milestone in for our long-standing network of more than 26 level 3 units. We have achieved our primary aim this year which was to establish a formal infrastructure for the network. The appointment of Simon Boote as Network Manager has been a major step forward and in addition Leonie Wong has been appointed Deputy Network Director. Our network nurse appointment has been advertised. In December 2018, we held interviews for board members and we were thrilled that there was a lot of interest with more than ten applicants from the Paediatrician’s with Expertise in Cardiology (PECS) in our network. We have created a representative board including patient representatives, PECS and members of the wider MDT providing care to those with CHD from fetal life to old age. Our inaugural board meeting was held in January 2019 receiving positive feedback from all attendees including our commissioner, Hazel Fisher. We are delighted that Angela Tillett, Medical Director of Colchester University Hospital has agreed to be Chairman of our board. In addition, we have created a number of sub-committees including Technology, Quality and Safety, Pathways and Protocols, Transition and Patient experience. There have been exciting new PEC appointments and we are delighted to welcome Dr Prashanthi Katta as the second PEC in East Surrey Hospital (Surrey & Sussex Health Care) and Dr Rani Thankappen in Basildon. Both were post CCT trainees at the Royal Brompton Hospital facilitating seamless communication between our hospitals. We also continue to work extremely well with our experienced PECs in the network. We have continued our regular popular network training program holding 4 whole day sessions in the last twelve months including one at Harefield Hospital, one fetal network day to which obstetricians, midwives and neonatologists and PECS attended. We have also introduced governance sessions and invaluable important patient led sessions with parents and patients speaking. We continue to also regularly train PECS both as juniors on our Fellow rotation programme and more senior established PEC consultants with hands-on echo training provided by our highly specialised dynamic congenital echocardiography team on our inpatients and outpatients and also in the two formal echocardiography courses we run each year. We have one of the best trained PEC networks in the country with approximately one third having already achieved or passing through the European Association of Cardiovascular Imaging congenital echo accreditation process. Our nurses also continue their highly rated training days. Regarding research we have had 2 professorial appointments Piers Daubeney and Julene Carvalho as well as numerous publications and lectures given. At a national level our network has representation on the British Congenital Cardiac Association and a close collaborative working relationship with the PEC Specialist Interest Group. We also congratulate Sonya Babu-Narayan on her new appointment as Associate Medical Director of the British Heart Foundation. We are now preparing for peer review and are also pleased to be collaborating with Guys & St Thomas’, Evelina and Great Ormond Street Hospital hosting the next National Network Day. Issued: April 2019 Version: 001 Page | 4 Link - Contents Our major challenges for the year ahead include establishing a network website and better technology links to allow data particularly echocardiograms to be transferred seamlessly 24/7 across our network. We look forward to more successes and achievements in the following year. Yours sincerely, Dr Nitha Naqvi Network Director 3 RBH-CHD Network Strategic Vision Statement Our aim is the delivery of excellent clinical outcomes by world leading clinicians across an agile, open and communicative network that can meet the demands of congenital heart disease burden by leveraging innovations in technology, research, education, governance and patient care. We will achieve our strategic vision (Appendix 1) by agreeing quality improvement initiatives that align with our Core Pillars, and delivering these initiatives under the supervision of