Annex A > Chapter 11 - Referrals > Referrals to Bristol - evidence of the actual pattern of referrals from the South West of England
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Referrals to Bristol - evidence of the actual pattern of referrals from the South West of England
120 Both the cardiologists and the surgeons at Bristol were aware that some paediatricians within the catchment area were not routinely referring all or some of their patients to Bristol.
121 Mr Wisheart told the Inquiry:
`Hospitals in the South Western RHA: Plymouth referred nearly all children elsewhere, Yeovil referred a proportion elsewhere. Hospitals in the Wessex RHA: Swindon referred a significant proportion elsewhere. I do not know why ... ' [122]
`Most of the following hospitals either did not routinely refer or only referred a minority of patients to Bristol: Plymouth Hospitals, Yeovil District Hospital, Cardiff Hospitals.' [123]
He explained the referral patterns from Plymouth and Yeovil thus:
`I was, of course, aware that paediatricians in Plymouth and one in Yeovil were referring most of their patients to Southampton. The original reasons for this were geographical in the case of Yeovil and historical in relation to both sites, coupled with the fact that the surgical waiting lists in Bristol were longer than elsewhere.' [124]
`I believe it was an accepted reality that most paediatricians would support the nearest tertiary or specialty unit within their region, if (a) there was one present at their teaching institution, where these units tended to be located, and (b) they were satisfied with the overall management, both cardiological and cardiac surgical that their patients had received from us in the past.' [125]
However, Dr Joffe told the Inquiry:
`I have no knowledge of whether clinicians within Bristol's catchment area refer children to centres other than the BRI, except for those in Plymouth who refer their patients to Southampton. This has been the situation from well before my arrival in Bristol in 1980, and continues today despite the transfer of all paediatric open-heart surgery to BCH, and the excellent results being achieved currently. I don't know why, since I have had no dealings with them.' [126]
124 Asked what, in their view, referring clinicians thought of the service at Bristol, Dr Joffe said:
`As far as I could judge, the view held ... was generally positive and favourable. I cannot recall being confronted by any other clinician in the referring centres with adverse comments or concern about results.' [127]
`I cannot recall during my time as a consultant that any paediatricians in the regions expressed concerns about the service provided. I discussed on several occasions with some of the paediatricians in Plymouth, when they raised the issue, the possibility of sending more patients to Bristol. They certainly did not say that they considered the standard in Bristol was deficient. The advice which I gave was that I could not say that the standard of treatment they would receive in Bristol would be better than in other centres to which they were currently referring (notably Southampton) and that as Southampton had no waiting list and Bristol had considerable waiting lists I could see advantages in patients continuing to go to other centres.' [128]
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Footnotes
[122] WIT 0120 0118 Mr Wisheart
[123] WIT 0099 0035 Dr Jordan
[124] WIT 0099 0037 Dr Jordan
[125] WIT 0097 0291 Dr Joffe
[126] WIT 0097 0292 Dr Joffe
[127] WIT 0097 0290 Dr Joffe
[128] WIT 0099 0035 Dr Jordan (emphasis in original)