In March of this year, Royal Brompton Hospital (RBH) increased its intensive care capacity from 18 beds to 80 in order to accommodate critically unwell adults with Covid-19. As part of these measures, RBH’s paediatric ICU beds had to be re-purposed for adult patients. In response, the RBH and Evelina London cardiac teams worked together to arrange for all babies and children who required urgent cardiac procedures to be transferred to the Evelina for their operation.
Just over 70 babies and children referred by the Royal Brompton have had a surgical procedure at the Evelina London so far this year. Most of these procedures were carried out by Mr Guido Michielon, the Royal Brompton’s lead surgeon, and the remainder were carried out by the Evelina London surgeons. The Royal Brompton cardiology team have continued to provide follow-up care for these patients once they have had their operation and been discharged from the Evelina.
Paediatric surgical activity has now resumed at Royal Brompton Hospital. The cardiac teams at both sites continue to work increasingly closely together in the best interests of children, particularly over neonatal surgery whilst an additional surgeon is recruited. Although hospital admissions of patients with Covid-19 are rising again this autumn, the additional critical care capacity now available in London, and the lessons learned from the surge of admissions in the spring, mean that there are no plans to convert RBH paediatric ICU beds for adult Covid-19 patients again, except in the most extreme and unpredictable circumstances.
Subject to the agreement of both organisations, we expect Guy’s & St Thomas’ and Royal Brompton & Harefield to become a single NHS Foundation Trust early in 2021. Whilst this will further strengthen our close working, changes to where services are provided are subject to entirely separate approval processes, requiring public consultation.
We expect NHS England commissioners to present proposals for public consultation in 2021 regarding the future of the services. These proposals will set out the case for bringing the two services together in an expanded Evelina London Children’s Hospital, in around 5 years’ time once new facilities have been built. Both clinical teams are closely involved in developing these proposals, and representatives of ECHO and Brompton Fountain will be involved and consulted as our plans develop.
Dr Aaron Bell (Head of cardiac services, Evelina London) & Dr Jan Till (Divisional director of children’s cardiac services, Royal Brompton & Harefield)