Final Report > Chapter 8: Paediatric Cardiac Surgical Services > The planning and funding of paediatric cardiac surgery for children under 1 year of age (neonatal and infant cardiac surgery) > The consequences of designation as a supra regional centre for a local health service

The consequences of designation as a supra regional centre for a local health service

8 The importance of the designation of a particular centre as an SRS should not be overstated. Crucially, it did not constitute any permission or authorisation on the part of the SRSAG that the particular service could be carried out at the particular centre. Still less did it constitute a prohibition against providing that service in other centres. The SRSAG could not prevent developments elsewhere. All that it could do was foster developments in the centres it chose and, to the extent that patients might not benefit from treatment in non-designated centres, hope that others would not offer the service.

9 In practical terms, the designation of a particular service as an SRS meant that it was funded by `top-slicing' a levy each year from the funds allocated by Parliament for Hospital and Community Health Services. Those funds were then administered directly by the DHSS/DoH and distributed to the designated SRCs on the advice of the SRSAG. The funding was protected, and a hospital with an SRC thus obtained a guaranteed source of funding. This mattered during the period 1984-1995 when funding of the NHS generally was under very great pressure. Although accounting mechanisms at the time did not permit the money received to be specifically traced to expenditure on the particular SRS (it simply went into the hospital's overall income), SRS funding did give protection to the service concerned, if only because a hospital could not readily receive the SRS funding and at the same time fail to provide the service.