News item | 13-02-2023 | 15:38
Minister Kuipers (Public Health, Welfare and Sport) intends to concentrate the operations of children with a congenital heart defect in the UMC Groningen and the Erasmus MC. With this combination, the most optimal quality and accessibility of this care is expected for patients.
Importance concentration
Several studies, reports and advisory reports over the years have shown that concentration of pediatric heart surgery is necessary to reduce the risk of preventable complications and mortality. When operations continue to be performed in more than two centers, healthcare professionals perform too few operations to keep their skills up to date and the occupancy of the very limited number of professionals per center is too low. This puts pressure on the quality and continuity of this care.
On January 16, Minister Kuipers asked the Dutch Federation of University Medical Centers (NFU) to indicate before February 15 whether they themselves could choose the two locations where this care could best be concentrated. Last week, the NFU announced that it could not come to a decision itself. Minister Kuipers then took a proposed decision today for the concentration of these interventions. A final decision will be taken after those involved have been able to explain their views on this proposed decision.
Minister Kuipers: “The discussion about concentration of operations in patients with a congenital heart defect has been going on for thirty years, while it is widely shared that this is important for the quality and accessibility of care. Because the field itself unfortunately could not come to a decision, I made an intended decision myself. This provides clarity for all parties involved: for the healthcare professionals, the administrators, but much more importantly: for the patient.
UMC Groningen and Erasmus MC
Various previous reports, the impact analysis of the Dutch Healthcare Authority (NZa), discussions and information from the centers show that Erasmus MC is the largest center for pediatric heart surgery. Most operations are already being carried out there and the staffing is also the largest there. In addition, this center meets well the other aspects that have been assessed in order to reach this intended decision.
The other three centers would also be able to organize the care. But regional distribution and accessibility of care is an important factor in this decision, according to the impact analysis presented by the NZa in December of last year. It is therefore important that complex operations can continue to be performed at UMC Groningen. Minister Kuipers has therefore opted for the Erasmus MC and the UMCG. That does not mean that all care for heart patients in Utrecht and Leiden will disappear. On the contrary: check-ups, outpatient appointments, pre- and aftercare and discussions about medication can also take place for patients after concentration of operations in the familiar hospital, by their own specialist. This also applies, of course, to acute care.
Final decision
After the UMCs concerned have been able to express their views on this proposed decision no later than 27 February, a final decision will be taken. It goes without saying that time is needed to properly regulate the concentration of this care. The transition period is expected to last 2.5 years. In consultation with the NFU, Minister Kuipers will set up a committee of independent, authoritative experts to supervise the transition. The impact analysis of the NZa helps to shape the transition. The first step is to outline a clear perspective for all patients and healthcare professionals involved in the short term.