Editor—The unfortunate events relating to the General Medical Council’s recent inquiry into paediatric cardiac surgery performed at Bristol Royal Infirmary have been widely reported, both in the medical press and in the public media.1,2 Clearly in the past there was a major problem with this particular aspect of the service. The clinicians who now provide both the paediatric and adult cardiac service in Bristol support the efforts of the General Medical Council and any future public inquiry to resolve the matter fully.
In the mass of reporting, which was often written in a highly emotive style, it is easy to overlook the fact that the last of the events in question occurred some three years ago and the earliest occurred many years before that. Like many other centres, Bristol has been developing an audit programme in recent years, and we currently have a sophisticated audit system in the Bristol Royal Infirmary cardiac unit. This multidisciplinary computer database is completed for each cardiac surgical procedure, with 200 separate data fields entered for each patient. This allows many forms of analysis, including analysis of crude mortality, mortality adjusted for risk, and a wide range of other factors.
The results for the unit in 1997-8 are excellent as well as comprehensive and show that we are functioning as a cardiac surgical unit of the highest quality (table). There is no difference between the performance of any of the current surgical teams. Paediatric cardiac surgery, which has been performed at Bristol Royal Hospital for Sick Children since October 1995, is also carefully audited, and again our most recent figures from 1997-8 show excellent results (table). The data in the table confirm that the results for both adult and paediatric cardiac surgery are among the best that we know of in the United Kingdom. The full audit documents for both adult and paediatric cardiac surgery are in the final stages of preparation and will be made publicly available shortly. Patients, their families, their doctors, and other health professionals can be confident in the quality of care that is currently offered by our cardiac surgical service.
Table.
Number of cardiac operations done in Bristol on adults (at Bristol Royal Infirmary) and children (at Bristol Royal Hospital for Sick Children) in 1997-8, and mortality in same period
| Total No of procedures in Bristol | Mortality in Bristol (%) | Mortality in UK (1996-7) | |
|---|---|---|---|
| Bristol Royal Infirmary: | |||
| Total adult cardiac surgery operations | 1184 | 2.4 | 5.1 |
| Coronary artery bypass grafting | 831 | 0.8 | 3.7 |
| Bristol Royal Hospital for Sick Children: | |||
| Total of operations for congenital heart disease | 260 | 3.1 | 4.1 |
| Open heart operations before age of 1 year | 50 | 8.0 | 7.5 |
Most recent figures from Society of Cardiothoracic Surgeons of Great Britain.
References
- 1.Dyer C. Compensation claims expected to follow GMC’s findings. BMJ. 1998;316:1691. . (6 June.) [Google Scholar]
- 2.Delamothe T. Who killed Cock Robin? BMJ. 1998;316:1757. doi: 10.1136/bmj.316.7146.1757. . (6 June.) [DOI] [PMC free article] [PubMed] [Google Scholar]