Final Report > Chapter 16: The Organisation of the Paediatric Cardiac Surgical Service in Bristol > The paediatric cardiologists' role
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The paediatric cardiologists' role
21 The children were admitted to the BRHSC under the joint care of cardiologists and surgeons. [19] On admission to the BRI, Mr Wisheart told us that a child would be reassessed not only by a surgeon, but also by a paediatric cardiologist from the BRHSC, as well as being seen by the anaesthetist for the first time. [20] Dr Jordan, consultant paediatric cardiologist, and Dr Joffe, however, both told the Inquiry that the role of the cardiologist in immediate pre- and post-operative care was limited because of their heavy workload, the absence of support from junior staff, and the need to visit the outreach clinics which extended across the South West and South Wales. [21] There was, it will be recalled, a significant national shortage of paediatric cardiologists at that time. Dr Jordan told us that the cardiologists' attempts to meet the surgeons to look at the results of the various tests carried out on the child, in preparation for the following week's operations, fell by the wayside. They were, he said, just too busy. [22]
22 As has been said, the meetings between cardiologist and surgeon were a casualty of the cardiologists being overstretched. Dr Houston, one of our Experts in paediatric cardiology, told us, however, that it was imperative for the cardiologists and surgeons to meet before an operation to review the notes and examine the test results together.
23 Similarly, and more importantly, given that open-heart surgery was carried out at the BRI, there were difficulties for the cardiologists in becoming involved in care at the BRI, either on the ward or in the operating theatre. Dr Joffe, consultant paediatric cardiologist, found it difficult to get actively involved. He told us that: `Dr Jordan specifically made a point of going to the BRI every day and often twice a day, and found it slightly easier than I [Dr Joffe] did because earlier on he was still involved in adult cardiology, [and] had an office at the BRI.' [23]
24 Dr Joffe initially had an office at the BRI and Dr Jordan had an office there until the late 1980s. Thereafter, both were based at the BRHSC. Dr Joffe said that the physical separation between the BRI and BRHSC, although only about 150 to 200 metres, was: `real although of course not insurmountable' because the BRHSC was up an `extremely steep' hill. Dr Joffe told us that: `the separation made a difference in terms of the ordinary communication that exists in a unit where consultants and various doctors can meet with each other and bump into each other in a corridor, and so on, which facilitates overall management.' [24]
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Footnotes
[19] WIT 0120 0126 Mr Wisheart
[20] WIT 0120 0127 Mr Wisheart
[21] WIT 0097 0297 Dr Joffe and WIT 0099 0040 - 0041 Dr Jordan