Annex A > Chapter 11 - Referrals > Referrals to Bristol - referral procedure, the catchment area and finance > The catchment area
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The catchment area
17 Bristol had historically provided a paediatric cardiac service to its catchment area. As the 1982 memorandum [11] prepared by Dr Joffe, Dr Jordan and Mr Wisheart put it:
`The paediatric cardiology service already functions as the de facto Regional and Supra Regional Centre (although not yet officially recognised as such), drawing 28% of new referrals to the unit from Avon, 48% from the rest of the SW Region and 24% from South Wales, North Wessex and elsewhere. ...
`The long term management of patients is supervised near their homes through a system of Consultant Cardiac Clinics developed over many years and probably more comprehensive than in any other paediatric cardiology service in England. Regular peripheral clinics are held in Bath, Swindon, Cheltenham, Gloucester, Taunton, Barnstaple, Exeter, Torquay, Plymouth and Truro. Close liaison exists with paediatricians in all these centres, who would resist any curtailment in the services they and their patients receive.'
18 Mr Wisheart said that referrals to the Bristol cardiologists came from:
- `All the District General Hospitals in the old South Western RHA territory, except ... Plymouth, who referred most of the children to Southampton, Yeovil who referred a proportion of their children to Southampton.
- `Bath and Swindon in the old Wessex Regional Health Authority territory. I do not know whether they sent all their children to Bristol, but I believe that Bath did send virtually all its patients to Bristol, while Swindon sent a significant proportion of its referrals to Oxford, or possibly Southampton.
- `A number of District General Hospitals in South Wales. The number of hospitals in South Wales referring to Bristol has varied over the period 1984 to 1995. There were some centres referring in 1984; this increased through the mid and late 80s when there was no cardiological facility in Cardiff. After the setting up [of] the paediatric cardiological facility there, the number of DGHs using Bristol decreased.
- `The General Practices, which before 1991 were within the Bristol and Weston Health Authority, and possibly also the Southmead and Frenchay Health Authorities. After 1991 the practices within the corresponding Trusts.' [12]
19 Dr Jordan [13] and Dr Joffe each provided the Inquiry with a list of the hospitals from which children were referred to them. [14] The hospitals named by them were:
South Western Region:
Gloucestershire Royal Hospital (Gloucester)
Cheltenham General Hospital (Cheltenham)
Musgrove Park Hospital (Taunton)
Royal Devon and Exeter Hospital (Exeter)
North Devon District Hospital (Barnstaple)
Royal Cornwall Hospital (Truro)
Wessex:
Princess Margaret Hospital (Swindon)
South Wales:
Royal Gwent Hospital (Newport)
East Glamorgan Hospital (Mid Glamorgan)
Princess of Wales Hospital (Bridgend)
Morriston (formerly Singelton) Hospital (Swansea)
West Wales General Hospital (Carmarthen)
Withybush Hospital (Haverfordwest)
Neath General Hospital (Neath)
Nevill Hall Hospital (Abergavenny) [15]
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Footnotes
[11] Memorandum on the Designation of Bristol as a Supra Regional Centre (SRC) in Neonatal and Infant Cardiology and Cardiac Surgery, July 1982, JDW 0001 0150 - 0152 , and see further Chapter 7 where designation of Bristol as a Supra Regional Centre is discussed
[12] WIT 0120 0116 Mr Wisheart
[13] Dr Jordan told the Inquiry: `Essentially all patients from consultant paediatricians in [these] hospitals were sent to Bristol', although in relation to the Royal Devon and Exeter he said `possibly not all Dr Kennaird's "cold" referrals', and in relation to Swindon `latterly some were sent to Oxford'. See WIT 0099 0035 Dr Jordan
[14] Dr Jordan's list is at WIT 0099 0035 and Dr Joffe's at WIT 0097 0290
[15] See also figures for referrals from the catchment area and `outreach' clinics in the Annual Reports of the Bristol Paediatric Cardiology and Cardiac Surgery Unit for 1987 (UBHT 0166 0001 - 0014 ) and 1988 (UBHT 0124 0006 - 0016 )