Royal Brompton Hospital
Encyclopedia
Royal Brompton Hospital is the largest specialist heart and lung centre in the United Kingdom (UK).
The hospital is part of Royal Brompton & Harefield NHS Foundation Trust is a national and international specialist heart and lung centre based in Chelsea, London and Harefield
, Middlesex. The Trust helps patients from all age groups who have heart and lung problems and is the country's largest centre for the treatment of adult congenital heart disease.
. At the time consumptive patients were turned away from other hospitals as there was no known cure. Hospitals that dealt with such infectious disease
s later came to be known as sanatorium
s. The prospectus for the Hospital stated that for the last 6 months of 1837 out of 148,701 deaths from all causes, 27,754 were from consumption.
, the first meeting to establish the Hospital was on 8 March 1841. It was to be known as The Hospital for Consumption and Diseases of the Chest. It amalgamated on 25 May 1841 with The West London Dispensary for Diseases of the Chest, which was based at 83 Wells Street, near Oxford Street. Little is now known about the Dispensary. On 28 March 1842, an out-patients branch of the hospital was opened at 20 Great Marlborough Street
. Later that year they acquired a lease on their first building for in-patients at The Manor House, Chelsea, which held space for 20 beds and the first in-patients were admitted on 13 September 1842. Admittance was to be by the then customary method of recommendation by the Governors and subscribers. Manor House remained in use as a convalescence home after the hospital had moved to the Brompton site.
. Rose travelled the country to explain the aims of the hospital, setting up 14 provincial associations, 157 churches promised to preach special sermons as a means of fund raising. The famous singer, Jenny Lind
also gave concerts, including one at Her Majesty's Theatre
in July 1848, which raised £1,606.
Besides Philip Rose, the early supporters included William Augustus Guy
, Charles Dickens
, and Queen Victoria, who became a patron, with an annual subscription of £10.
building with red brick and blue diapering with Portland stone
mouldings. One of the features of the building was the inclusion of ventilation by forced warm air in an attempt to create a temperature more commonly found in more southern latitudes. The total cost for the west wing and part of the centre was £11,762. The first admission of patients was in 1847. Whilst the east wing was completed in 1849.
The hospital acquired houses on the south side of the Brompton Road in 1868 with a plan to connect to the main building with a tunnel, which was completed in 1873. The hospital continued to purchase houses on the south side and eventually developed the site to become the south block of the Brompton, which was formerly opened by the President of the Corporation, The Earl of Derby
on 13 June 1882. Without the bequest of Miss Cordelia Angelica Read of some £100,000 the hospital may never have been built. The building was in an "E" shape and constructed of red brick and Ancaster stone
. The basement contained a compressed air
room and a Turkish bath (both of which were considered beneficial to tuberculosis sufferers at the time. There were also facilities for a large outpatients department, rooms for resident staff and a lecture room and ten wards holding from 1 to 8 beds. The total cost was said to be £65,976.
), two miles (3 km) from Frimley
Railway Station for £3,900. The architect, Edwin T. Hall
, designed a two-storied stellate block, rising to three-stories for the centre, the four radial pavilions would contain the majority of wards, most of which would be single bedded and the ability to wheel the beds onto a terrace to "be under the full influence of the sunshine and the atmosphere." A second group of buildings was to contain dining rooms, recreation rooms, kitchens and offices and accommodation for medical staff. Besides accommodation for staff, 2 houses and a nurses block, no further buildings were erected on the site until its closure in 1985.
The formal opening of the sanatorium was on 25 June 1904 with the ceremony performed by the Prince of Wales
(later King George V), but because of unresolved problems regarding heating, plumbing and staff the first patients weren’t admitted until March 1905.
Marcus Paterson, who had been a house physician at the Brompton from 1901, accepted a post at Frimley in 1905, becoming the Medical Superintendent in January 1906. Paterson was known to say, “it would make them (the patients) more resistant to the disease by improving their physical condition.” To this end he introduced what was one of the first attempts at systematic rehabilitation.
At an International Congress on Tuberculosis
held in 1908 in Washington, USA
the $1,000 first prize was shared between Frimley, for a model of the sanatorium, which had partly been made by patients, and an American institution,. Further awards of $500 went to Paterson for his essay on Frimley and $1,000 to Arthur Latham, an assistant-physician at The Brompton for his paper on the treatment of more advanced cases of tuberculosis.
in Bournemouth
, to be financially independent, to "receive those cases where convalescence has been established." Although more of a convalescent home, rather than a sanatorium as the word was understood later, it was the first of any such establishment anywhere in the world. It was specially built, the architect being E B Lamb, who had previously built the chapel attached to the Hospital in Brompton Road. The sanatorium opened in October 1855. Later to become independent of the hosptial and known as The Royal National Sanatorium : Bournemouth. The site has now been re-developed into a retirement complex known as "Brompton Court," but the chapel has been retained.
on the ship, Maria Pia, which set sail on the 7 November 1864. When the patients returned some months later it was discerned that there had been no noticeable improvement in the patients and the experiment was discontinued.
. This was discontinued in 1900 with the future development at Frimley in mind.
in 1922, to receive "the most miserable, undersized and debilitated children" attending the dispensary, 37 children were sent the first year. The children were chosen from the poorest homes, no lessons were given but "organised games and eurythmics
" were the order of the day. Later another hut was built for children not living in Chelsea. St. Andrew's Home closed in 1932.
is a national and international leader in the treatment of heart and lung disease and is renowned for its pioneering transplant unit.
Harefield Hospital is one of the largest and most experienced centres in the world for heart and lung transplants. In 1983, a team of doctors led by the eminent Prof Sir Magdi Yacoub
performed Britain’s first heart-lung transplant.
in Canada.
In 2009 Royal Brompton & Harefield became a foundation trust inside the NHS, giving it new freedom to run its own finances and borrow money.
On Monday 5 July 2010, the new National Institute for Health Research (NIHR) Respiratory Biomedical Research Unit (BRU) Clinical Research Facility opened at the Royal Brompton Hospital.
Funded and supported by the NIHR and the Royal Brompton Hospital Charitable Trustees, the Respiratory BRU puts the Trust and its academic partner Imperial College London at the forefront of international research into the most challenging lung conditions. It aims to:
On Monday 15 November 2010, the new National Institute for Health Research (NIHR) Cardiovascular Biomedical ResearchUnit opened at Royal Brompton Hospital, a joint initiative with academic partner Imperial College London.
As part of the NIHR, the cardiovascular BRU puts the Trust and Imperial at the forefront of international
research into the most challenging heart conditions.
Research at the cardiovascular BRU will concentrate on increasing the understanding of poor heart function
in people living with cardiomyopathy (inherited heart muscle disease), arrhythmia (irregular heart-beat),
coronary heart disease and heart failure. This will be achieved by:
Children’s heart surgery is complex and becoming increasingly specialised. It is currently provided in 11 centres across England. Following longstanding concerns that some congenital heart services for children are too small to be able to deliver a safe and sustainable service, the National Specialised Commissioning Team undertook a review into the future of children’s congenital heart services in England led by the Safe and Sustainable Team.
In February 2011, the recommendations from the review were agreed by the Joint Committee of PCTs (JCPCT), and the National Specialised Commissioning Team then began a public consultation on the options, which recommend that the number of specialist centres in England is reduced from 11 to six or seven.
It is proposed that despite Royal Brompton Hospital’s exceptional performance, size and safety record, the service is closed because London only requires two centres to develop a congenital heart network and that Great Ormond Street Children’s Hospital and the Evelina Children’s Hospital are the preferred options for this.
• The Trust’s performance is rated ‘excellent’ by the Care Quality Commission and its record in children’s heart services is particularly strong: the Trust has an aggregate mortality rate of 0.94% for congenital interventions and surgery, against a national average of 2%
• The pre-business case review recognised the hospital's excellence, ranking its service joint-third with Great Ormond Street out of all eleven centres in England
• Royal Brompton Hospital has an international reputation for its specialist paediatric services. Its experts sit on, and chair, international advisory panels and professional bodies throughout the world and share their knowledge through teaching both in the UK and abroad. Their research collaborations cross international boundaries
Cardiac services for children do not exist in a vacuum. They are supported by other disciplines such as intensive care and anaesthesia. The Trust believes the consultation neglected to take account of the wider implications that removing children’s cardiac surgery will have on the Trust and its patients:
• The entire paediatric unit would collapse. Without children’s cardiac surgery the hospital’s paediatric intensive care unit would close immediately, as the number of patients needing it would not be enough to make it financially viable. Without paediatric anaesthesia and intensive care, the life-saving work of the hospital’s respiratory teams would also cease - both anaesthesia and intensive care are needed for many respiratory procedures, such as high-risk bronchoscopy
• The adult congenital heart disease unit would be de-stabilised. Within one to two years the effect of losing paediatric heart services would adversely impact Royal Brompton ’s adult service, which cares for more patients with congenital heart disease than anywhere else in the UK. Many of them are treated for pulmonary hypertension by another group of specialists within the Trust, one of just six centres in the UK accredited to treat this disease
• The health needs of 300 children with cystic fibrosis. The hospital hosts the largest service for children with cystic fibrosis in the country. Any re-configuration therefore must include a detailed plan for the break-up and re-distribution of services such as the Royal Brompton’s specialist paediatric cystic fibrosis service, one of the largest in the UK, and the dispersal and re-location of its expert teams of staff. The detrimental impact on Royal Brompton’s adult cystic fibrosis unit, acknowledged as one of the leading centres in Europe, would soon be seen: 70-80% of adult patients progress from the paediatric service
In March 2011, Royal Brompton & Harefield NHS Foundation Trust issued legal proceedings against the Joint Committee of PCTs (JCPCT) in respect of the proposal to end paediatric cardiac surgery at Royal Brompton Hospital, as part of the ‘Safe and Sustainable’ review. The Trust’s board believes that the recommended options put to public consultation are fundamentally flawed, such that a consultation based on them would be unlawful. Two separate approaches have been made to the JCPCT in order to avoid legal action. The JCPCT rejected the first request to delay the start of the consultation to enable discussions to take place, and failed to respond to the second request to suspend the consultation while the Trust’s concerns were heard. The Trust is now applying for judicial review, challenging the legality of the consultation.
On 15 July 2011 the Trust was granted permission for a judicial hearing regarding the Safe and Sustainable consultation, which is due to take place later in the year.
More information about the Safe and Sustainable review and the Trust’s response to it is available on the Trust's website.
On 7 November, Mr Justice Owen concluded that the consultation on the ‘Safe & Sustainable’ review of children’s heart surgery was unlawful. Justice Owen stated that Royal Brompton & Harefield NHS Foundation Trust’s challenge to the consultation succeeds on the grounds that the consultation process was unfair to the Trust: "…the unfairness being of such a magnitude as to lead to the conclusion that the process went radically wrong". He concluded: "…in my judgement the consultation exercise was unlawful, and must therefore be quashed." Read the hospital's press release here.
The hospital is part of Royal Brompton & Harefield NHS Foundation Trust is a national and international specialist heart and lung centre based in Chelsea, London and Harefield
Harefield
Harefield is a village in the London Borough of Hillingdon in northwest London, England. It is situated on top of a hill, northwest of Charing Cross, near the Greater London boundary with Buckinghamshire to the west and Hertfordshire to the north...
, Middlesex. The Trust helps patients from all age groups who have heart and lung problems and is the country's largest centre for the treatment of adult congenital heart disease.
Consumption in the 19th Century
In the 19th century, consumption was a common word for tuberculosisTuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. At the time consumptive patients were turned away from other hospitals as there was no known cure. Hospitals that dealt with such infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
s later came to be known as sanatorium
Sanatorium
A sanatorium is a medical facility for long-term illness, most typically associated with treatment of tuberculosis before antibiotics...
s. The prospectus for the Hospital stated that for the last 6 months of 1837 out of 148,701 deaths from all causes, 27,754 were from consumption.
The beginning
The hospital was founded in the 1840s by Philip RosePhilip Rose
Sir Philip Rose, 1st Baronet was the son of William Rose, an Assistant Surgeon in the British Indian Army and Charlotte Rose ....
, the first meeting to establish the Hospital was on 8 March 1841. It was to be known as The Hospital for Consumption and Diseases of the Chest. It amalgamated on 25 May 1841 with The West London Dispensary for Diseases of the Chest, which was based at 83 Wells Street, near Oxford Street. Little is now known about the Dispensary. On 28 March 1842, an out-patients branch of the hospital was opened at 20 Great Marlborough Street
Great Marlborough Street
Great Marlborough Street runs west to east through the western part of Soho in London. At its western end it joins Regent Street. Streets intersecting, or meeting with, Great Marlborough Street are, from west to east, Kingly Street, Argyll Street, Carnaby Street, and Poland Street...
. Later that year they acquired a lease on their first building for in-patients at The Manor House, Chelsea, which held space for 20 beds and the first in-patients were admitted on 13 September 1842. Admittance was to be by the then customary method of recommendation by the Governors and subscribers. Manor House remained in use as a convalescence home after the hospital had moved to the Brompton site.
Funding
In common with other hospitals at the time, the hospital was to be financed entirely from charitable donations, legacies and fund raisingFundraising
Fundraising or fund raising is the process of soliciting and gathering voluntary contributions as money or other resources, by requesting donations from individuals, businesses, charitable foundations, or governmental agencies...
. Rose travelled the country to explain the aims of the hospital, setting up 14 provincial associations, 157 churches promised to preach special sermons as a means of fund raising. The famous singer, Jenny Lind
Jenny Lind
Johanna Maria Lind , better known as Jenny Lind, was a Swedish opera singer, often known as the "Swedish Nightingale". One of the most highly regarded singers of the 19th century, she is known for her performances in soprano roles in opera in Sweden and across Europe, and for an extraordinarily...
also gave concerts, including one at Her Majesty's Theatre
Her Majesty's Theatre
Her Majesty's Theatre is a West End theatre, in Haymarket, City of Westminster, London. The present building was designed by Charles J. Phipps and was constructed in 1897 for actor-manager Herbert Beerbohm Tree, who established the Royal Academy of Dramatic Art at the theatre...
in July 1848, which raised £1,606.
Besides Philip Rose, the early supporters included William Augustus Guy
William Guy
William Augustus Guy was a British physician and medical statistician.-Life:He was born in Chichester and educated at Christ's Hospital and Guy's Hospital; he then studied at the University of Heidelberg and the University of Paris before getting a Bachelor of Medicine degree from the University...
, Charles Dickens
Charles Dickens
Charles John Huffam Dickens was an English novelist, generally considered the greatest of the Victorian period. Dickens enjoyed a wider popularity and fame than had any previous author during his lifetime, and he remains popular, having been responsible for some of English literature's most iconic...
, and Queen Victoria, who became a patron, with an annual subscription of £10.
The move to Brompton
The area known as Brompton was no more than a village surrounded by market gardens, but quickly developed in the 1840s. The hospital acquired a market garden site there from a charity to erect a new hospital, with the architect being Frederick John Francis. The stone laying for the west wing was on 11 June 1844 by Prince Albert, the Prince Consort, the building being described as a beautiful ElizabethanTudor style architecture
The Tudor architectural style is the final development of medieval architecture during the Tudor period and even beyond, for conservative college patrons...
building with red brick and blue diapering with Portland stone
Portland stone
Portland stone is a limestone from the Tithonian stage of the Jurassic period quarried on the Isle of Portland, Dorset. The quarries consist of beds of white-grey limestone separated by chert beds. It has been used extensively as a building stone throughout the British Isles, notably in major...
mouldings. One of the features of the building was the inclusion of ventilation by forced warm air in an attempt to create a temperature more commonly found in more southern latitudes. The total cost for the west wing and part of the centre was £11,762. The first admission of patients was in 1847. Whilst the east wing was completed in 1849.
The hospital acquired houses on the south side of the Brompton Road in 1868 with a plan to connect to the main building with a tunnel, which was completed in 1873. The hospital continued to purchase houses on the south side and eventually developed the site to become the south block of the Brompton, which was formerly opened by the President of the Corporation, The Earl of Derby
Edward Stanley, 15th Earl of Derby
Edward Henry Stanley, 15th Earl of Derby KG, PC, FRS , known as Lord Stanley from 1844 to 1869, was a British statesman...
on 13 June 1882. Without the bequest of Miss Cordelia Angelica Read of some £100,000 the hospital may never have been built. The building was in an "E" shape and constructed of red brick and Ancaster stone
Ancaster stone
Ancaster stone is Middle Jurassic oolitic limestone, quarried around Ancaster, Lincolnshire, England. There are three forms of this limestone, Weather Bed, Hard White and Freestone...
. The basement contained a compressed air
Compressed air
Compressed air is air which is kept under a certain pressure, usually greater than that of the atmosphere. In Europe, 10 percent of all electricity used by industry is used to produce compressed air, amounting to 80 terawatt hours consumption per year....
room and a Turkish bath (both of which were considered beneficial to tuberculosis sufferers at the time. There were also facilities for a large outpatients department, rooms for resident staff and a lecture room and ten wards holding from 1 to 8 beds. The total cost was said to be £65,976.
Frimley
On 13 September 1900 the Hospital acquired 20 acres (80,937.2 m²) of planted forestry at Chobham Ridge (which is 400 feet (121.9 m) above sea levelAbove mean sea level
The term above mean sea level refers to the elevation or altitude of any object, relative to the average sea level datum. AMSL is used extensively in radio by engineers to determine the coverage area a station will be able to reach...
), two miles (3 km) from Frimley
Frimley
Frimley is a small English town situated 2 miles south of Camberley, in the extreme west of Surrey, adjacent to the border with Hampshire. It is about 31 miles west south-west of Central London. It is part of the Borough of Surrey Heath...
Railway Station for £3,900. The architect, Edwin T. Hall
Edwin T. Hall
Edwin Thomas Hall was a British architect known primarily for the design of the Liberty & Co. department store, the Old Library at Dulwich College and various hospitals...
, designed a two-storied stellate block, rising to three-stories for the centre, the four radial pavilions would contain the majority of wards, most of which would be single bedded and the ability to wheel the beds onto a terrace to "be under the full influence of the sunshine and the atmosphere." A second group of buildings was to contain dining rooms, recreation rooms, kitchens and offices and accommodation for medical staff. Besides accommodation for staff, 2 houses and a nurses block, no further buildings were erected on the site until its closure in 1985.
The formal opening of the sanatorium was on 25 June 1904 with the ceremony performed by the Prince of Wales
George V of the United Kingdom
George V was King of the United Kingdom and the British Dominions, and Emperor of India, from 6 May 1910 through the First World War until his death in 1936....
(later King George V), but because of unresolved problems regarding heating, plumbing and staff the first patients weren’t admitted until March 1905.
Marcus Paterson, who had been a house physician at the Brompton from 1901, accepted a post at Frimley in 1905, becoming the Medical Superintendent in January 1906. Paterson was known to say, “it would make them (the patients) more resistant to the disease by improving their physical condition.” To this end he introduced what was one of the first attempts at systematic rehabilitation.
At an International Congress on Tuberculosis
International Congress on Tuberculosis
The International Congresses on Tuberculosis are a series of international medical conferences on the communicable disease tuberculosis,-Sixth:...
held in 1908 in Washington, USA
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
the $1,000 first prize was shared between Frimley, for a model of the sanatorium, which had partly been made by patients, and an American institution,. Further awards of $500 went to Paterson for his essay on Frimley and $1,000 to Arthur Latham, an assistant-physician at The Brompton for his paper on the treatment of more advanced cases of tuberculosis.
Bournemouth
In 1850 The Medical Committee decided to build a small sanatoriumSanatorium
A sanatorium is a medical facility for long-term illness, most typically associated with treatment of tuberculosis before antibiotics...
in Bournemouth
Bournemouth
Bournemouth is a large coastal resort town in the ceremonial county of Dorset, England. According to the 2001 Census the town has a population of 163,444, making it the largest settlement in Dorset. It is also the largest settlement between Southampton and Plymouth...
, to be financially independent, to "receive those cases where convalescence has been established." Although more of a convalescent home, rather than a sanatorium as the word was understood later, it was the first of any such establishment anywhere in the world. It was specially built, the architect being E B Lamb, who had previously built the chapel attached to the Hospital in Brompton Road. The sanatorium opened in October 1855. Later to become independent of the hosptial and known as The Royal National Sanatorium : Bournemouth. The site has now been re-developed into a retirement complex known as "Brompton Court," but the chapel has been retained.
Madeira
The Hospital paid for the passage of 20 patients with tuberculosis to be taken to MadeiraMadeira
Madeira is a Portuguese archipelago that lies between and , just under 400 km north of Tenerife, Canary Islands, in the north Atlantic Ocean and an outermost region of the European Union...
on the ship, Maria Pia, which set sail on the 7 November 1864. When the patients returned some months later it was discerned that there had been no noticeable improvement in the patients and the experiment was discontinued.
Sandgate
Towards the end of the 19th Century the idea that sea air could be beneficial grew in popularity in medical circles and the Hospital, with help from the London Samaritan Society sent people to Bournemouth and SandgateSandgate, Kent
Sandgate is a village in the Folkestone and Hythe Urban Area in the Shepway district of Kent, England. In 2004, the village re-acquired civil parish status....
. This was discontinued in 1900 with the future development at Frimley in mind.
Hayling Island
The hospital erected a hut at St. Andrew's Home, Hayling IslandHayling Island
-Leisure activities:Although largely residential, Hayling is also a holiday, windsurfing and sailing centre, the site where windsurfing was invented....
in 1922, to receive "the most miserable, undersized and debilitated children" attending the dispensary, 37 children were sent the first year. The children were chosen from the poorest homes, no lessons were given but "organised games and eurythmics
Eurhythmics
Dalcroze Eurhythmics, also known as the Dalcroze Method or simply Eurhythmics, is one of several developmental approaches including the Kodaly Method, Orff Schulwerk, Simply Music and Suzuki Method used to teach music education to students. Eurhythmics was developed in the early 20th century by...
" were the order of the day. Later another hut was built for children not living in Chelsea. St. Andrew's Home closed in 1932.
Harefield Hospital
Harefield HospitalHarefield Hospital
Harefield Hospital is located in Harefield, Middlesex. It is part of the Royal Brompton & Harefield NHS Foundation Trust, which describes itself as "the largest specialist heart and lung centre in the UK and among the largest in Europe". Harefield's sister hospital is the Royal Brompton Hospital in...
is a national and international leader in the treatment of heart and lung disease and is renowned for its pioneering transplant unit.
Harefield Hospital is one of the largest and most experienced centres in the world for heart and lung transplants. In 1983, a team of doctors led by the eminent Prof Sir Magdi Yacoub
Magdi Yacoub
Sir Magdi Habib Yacoub, FRS , is Professor of Cardiothoracic Surgery at Imperial College London.Yacoub's major achievements may be summarised:1. Established Heart Transplantation in UK and became leading transplant surgeon in the world....
performed Britain’s first heart-lung transplant.
The hospital in the 21st Century
In 2005 the trust took on a new CEO, Bob Bell, who had previously been president and CEO at the William Osler Health CentreWilliam Osler Health Centre
William Osler Health System is one of the largest hospital corporations in the Canadian province of Ontario. It serves a geographic area of over 2,400 square kilometres including Brampton and Etobicoke. It provides programs and services to over 900,000 residents of those and surrounding communities...
in Canada.
In 2009 Royal Brompton & Harefield became a foundation trust inside the NHS, giving it new freedom to run its own finances and borrow money.
On Monday 5 July 2010, the new National Institute for Health Research (NIHR) Respiratory Biomedical Research Unit (BRU) Clinical Research Facility opened at the Royal Brompton Hospital.
Funded and supported by the NIHR and the Royal Brompton Hospital Charitable Trustees, the Respiratory BRU puts the Trust and its academic partner Imperial College London at the forefront of international research into the most challenging lung conditions. It aims to:
- Develop research teams by creating six new Consortia in key advanced lung diseases to progress future research and improve treatment for patients.
- Provide the core facilities, including the new Clinical Research Facility, needed by the Consortia to undertake their work.
- Encourage greater participation from patients and the public on research projects.
- Facilitate the training of health professionals in Advanced Lung Disease.
On Monday 15 November 2010, the new National Institute for Health Research (NIHR) Cardiovascular Biomedical ResearchUnit opened at Royal Brompton Hospital, a joint initiative with academic partner Imperial College London.
As part of the NIHR, the cardiovascular BRU puts the Trust and Imperial at the forefront of international
research into the most challenging heart conditions.
Research at the cardiovascular BRU will concentrate on increasing the understanding of poor heart function
in people living with cardiomyopathy (inherited heart muscle disease), arrhythmia (irregular heart-beat),
coronary heart disease and heart failure. This will be achieved by:
- Faster identification of genes linked to heart disease with a view to providing more personalised treatment for patients in the future.
- Improving imaging techniques to diagnose patients more accurately and monitor any changes occurring in the heart.
- Conducting clinical trials to investigate new treatments or advancements to improve current medical care.
- Developing new techniques such as gene therapy and stem cell therapy.
Safe and Sustainable paediatric cardiac surgery review 2011
Congenital heart disease is an abnormality in the heart that develops in the womb and is present at birth. Around one in every 133 children is affected . It is a life-long, and potentially life-threatening, condition.Children’s heart surgery is complex and becoming increasingly specialised. It is currently provided in 11 centres across England. Following longstanding concerns that some congenital heart services for children are too small to be able to deliver a safe and sustainable service, the National Specialised Commissioning Team undertook a review into the future of children’s congenital heart services in England led by the Safe and Sustainable Team.
In February 2011, the recommendations from the review were agreed by the Joint Committee of PCTs (JCPCT), and the National Specialised Commissioning Team then began a public consultation on the options, which recommend that the number of specialist centres in England is reduced from 11 to six or seven.
It is proposed that despite Royal Brompton Hospital’s exceptional performance, size and safety record, the service is closed because London only requires two centres to develop a congenital heart network and that Great Ormond Street Children’s Hospital and the Evelina Children’s Hospital are the preferred options for this.
The Trust's arguments against such a closure
• The Trust’s performance is rated ‘excellent’ by the Care Quality Commission and its record in children’s heart services is particularly strong: the Trust has an aggregate mortality rate of 0.94% for congenital interventions and surgery, against a national average of 2%
• The pre-business case review recognised the hospital's excellence, ranking its service joint-third with Great Ormond Street out of all eleven centres in England
• Royal Brompton Hospital has an international reputation for its specialist paediatric services. Its experts sit on, and chair, international advisory panels and professional bodies throughout the world and share their knowledge through teaching both in the UK and abroad. Their research collaborations cross international boundaries
The impact for patients and staff
Cardiac services for children do not exist in a vacuum. They are supported by other disciplines such as intensive care and anaesthesia. The Trust believes the consultation neglected to take account of the wider implications that removing children’s cardiac surgery will have on the Trust and its patients:
• The entire paediatric unit would collapse. Without children’s cardiac surgery the hospital’s paediatric intensive care unit would close immediately, as the number of patients needing it would not be enough to make it financially viable. Without paediatric anaesthesia and intensive care, the life-saving work of the hospital’s respiratory teams would also cease - both anaesthesia and intensive care are needed for many respiratory procedures, such as high-risk bronchoscopy
• The adult congenital heart disease unit would be de-stabilised. Within one to two years the effect of losing paediatric heart services would adversely impact Royal Brompton ’s adult service, which cares for more patients with congenital heart disease than anywhere else in the UK. Many of them are treated for pulmonary hypertension by another group of specialists within the Trust, one of just six centres in the UK accredited to treat this disease
• The health needs of 300 children with cystic fibrosis. The hospital hosts the largest service for children with cystic fibrosis in the country. Any re-configuration therefore must include a detailed plan for the break-up and re-distribution of services such as the Royal Brompton’s specialist paediatric cystic fibrosis service, one of the largest in the UK, and the dispersal and re-location of its expert teams of staff. The detrimental impact on Royal Brompton’s adult cystic fibrosis unit, acknowledged as one of the leading centres in Europe, would soon be seen: 70-80% of adult patients progress from the paediatric service
Legal proceedings against the Joint Committee of PCTs
In March 2011, Royal Brompton & Harefield NHS Foundation Trust issued legal proceedings against the Joint Committee of PCTs (JCPCT) in respect of the proposal to end paediatric cardiac surgery at Royal Brompton Hospital, as part of the ‘Safe and Sustainable’ review. The Trust’s board believes that the recommended options put to public consultation are fundamentally flawed, such that a consultation based on them would be unlawful. Two separate approaches have been made to the JCPCT in order to avoid legal action. The JCPCT rejected the first request to delay the start of the consultation to enable discussions to take place, and failed to respond to the second request to suspend the consultation while the Trust’s concerns were heard. The Trust is now applying for judicial review, challenging the legality of the consultation.
On 15 July 2011 the Trust was granted permission for a judicial hearing regarding the Safe and Sustainable consultation, which is due to take place later in the year.
More information about the Safe and Sustainable review and the Trust’s response to it is available on the Trust's website.
On 7 November, Mr Justice Owen concluded that the consultation on the ‘Safe & Sustainable’ review of children’s heart surgery was unlawful. Justice Owen stated that Royal Brompton & Harefield NHS Foundation Trust’s challenge to the consultation succeeds on the grounds that the consultation process was unfair to the Trust: "…the unfairness being of such a magnitude as to lead to the conclusion that the process went radically wrong". He concluded: "…in my judgement the consultation exercise was unlawful, and must therefore be quashed." Read the hospital's press release here.
Famous physicians and nurses associated with The Brompton
- James Laidlaw MaxwellJames Laidlaw MaxwellJames Laidlaw Maxwell Senior was the first Presbyterian missionary to Taiwan . He served with the English Presbyterian Mission....
, PhysicianPhysicianA physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments... - John Scott Burdon-SandersonJohn Scott Burdon-SandersonSir John Scott Burdon-Sanderson, Bt., F.R.S. was an English physiologist born near Newcastle upon Tyne. A member of a well known Northumbrian family, he received his medical education at the University of Edinburgh and at Paris...
, Physician - R. F. Patrick CroninR. F. Patrick CroninRobert Francis Patrick Cronin, FRCPC, FACP, FRCP was a cardiologist, researcher, professor, and healthcare consultant who served as Dean of the Faculty of Medicine at McGill University from 1972 to 1977. Dr. Cronin became widely recognized for his work in developing countries...
Cardiologist - Sir William Fergusson, FRSWilliam FergussonSir William Fergusson, 1st Baronet FRCS FRS was a Scottish surgeon.-Biography:William Fergusson son of James Fergusson of Lochmaben, Dumfriesshire, was born at Prestonpans, East Lothian on 20 March 1808, and was educated first at Lochmaben and afterwards at the high school and University of...
, Consulting Surgeon, 1843–1876 - Malcolm Green (physician)
- Sir Richard QuainRichard QuainSir Richard Quain, 1st Baronet , was an Irish physician.He was born at Mallow-on-the-Blackwater, County Cork, and died in Harley Street, London....
, Physician, 1848–1855 - Robert KnoxRobert KnoxRobert Knox was a Scottish surgeon, anatomist and zoologist. He was the most popular lecturer in anatomy in Edinburgh before his involvement in the Burke and Hare body-snatching case. This ruined his career, and a later move to London did not improve matters...
, Physician, 1856–1862 - Sir Joseph (later Lord) ListerJoseph Lister, 1st Baron ListerJoseph Lister, 1st Baron Lister OM, FRS, PC , known as Sir Joseph Lister, Bt., between 1883 and 1897, was a British surgeon and a pioneer of antiseptic surgery, who promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary...
, Consulting-Surgeon, 1891–1912 - Ivan MagillIvan MagillSir Ivan Whiteside Magill was an Irish born anaesthetist who is famous for his involvement in much of the innovation and development in modern anaesthesia....
, anaesthetist, 1921- - David SouthallDavid SouthallProfessor David Southall, OBE, is a UK paediatrician who is a controversial expert in Fabricated or Induced Illness , and who has performed significant research into sudden infant death syndrome....
paediatrician - Sir Roger Gilbert BannisterRoger BannisterSir Roger Gilbert Bannister, CBE is an English former athlete best known for running the first recorded mile in less than 4 minutes...
, Athlete and neurologist, Junior member of staff at the hospital. - Sandy DennySandy DennySandy Denny , born Alexandra Elene Maclean Denny, was an English singer and songwriter, perhaps best known as the lead singer for the folk rock band Fairport Convention...
, (singer, started to train as a nurse mid- 1960s)
External links
- Research & Development in Royal Brompton and Harefield NHS Trust
- Royal Brompton's Department of Occupational and Environmental Lung Disease
- 19th Century Newspaper quotes about Brompton Consumption Hospital.
- British history online entry
- http://www1.imperial.ac.uk/nhli/