1999/0268
Frank Dobson, Secretary of State for Health, today announced that the Kasai portoenterostomy, a surgical procedure used to treat children with severe liver problems, will, with immediate effect, be provided from only three centres in England.
Mr Dobson has accepted the recommendation of the National Specialist Commisisoning Advisory Group that the procedure should be restricted to three centres: King''s College Hospital, London and Birmingham Children''s Hospital, the two national specialised paediatric liver disease centres, and The Leeds Teaching Hospitals, which will be developed during 1999/2000 to become the third national centre for this service.
The Kasai portoenterostomy is used to treat children with primary biliary atresia, the symptom of which is persistent severe jaundice. In the light of information that patient outcomes are improved if operated on in centres performing larger numbers of Kasai procedures, NSCAG initiated a consultation process. A meeting at the Department of Health on 11 March 1999 was attended by representatives from paediatric surgery, paediatric hepatology and children''s liver disease services and from the Children''s Liver Disease Foundation, representing parents and patients with liver disease. There was unanimous agreement that this procedure should be restricted to the three named centres.
Mr Dobson also announced that the Kasai procedure will be subject to an independent audit over the long term to ensure that all three units produce the best possible results for the small group of patients for whom it is necessary.
NOTES FOR EDITORS
1. The National Specialist Commissioning Advisory Group was set up in April 1996 and is responsible for advising the Secretary of State on the identification and funding of services under the Supra Regional arrangements as well as those not qualifying for supra regional designation but where there is a clinical and/or economic justification for commissioning their delivery centrally from a small number of units. It can also commission guidelines for local commissioners on services which, though appropriate to be commissioned locally are nevertheless for relatively rare conditions or procedures. Its fourth term of reference is to fund the service costs of new developments in those services for which it is likely to be the commissioner, to enable full evaluation to take place.
2. The Leeds Teaching Hospitals Unit has sufficient paediatric hepatology support currently to offer patients requiring a Kasai procedure a high standard of care. However, during 1999/2000 the NSCAG Secretariat will work with the Unit to agree and implement the required developments for it to become the third specialised paediatric liver service from April 2000.
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