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School of Medicine, Dentistry and Biomedical Sciences Centre for Infection and Immunity Queens University Health Sciences Building 97 Lisburn Road Belfast BT9 7BL 02890 972155 14 November 2011 Sir Neil McKay Safe & Sustainable Paediatric Congenital Cardiac Services, NHS Specialised Services, 2nd Floor Southside, 105 Victoria Street, London SW1E 6QT Dear Sir I am writing to express my concerns for the impact the proposed changes at RBH will have on the research programmes in childhood lung diseases. The quality of the current paediatric respiratory research programme at RBH is outstanding. It is one of very few centres with sustained internationally competitive programmes in the UK or mainland Europe. The investigators at RBH have published primary research which has resulted in changes in medical practice and the understanding of fundamental mechanisms of chronic lung diseases. The report by the panel of independent experts chaired by Adrian Pollitt clearly articulated the potential for adverse effects on the Royal Brompton’s research programme if the PICU became unviable as a result of the cessation of paediatric cardiac surgery. This is an important issue for two reasons. The first is that high quality research improves patient outcomes. This is a well recognised phenomenon in chronic disease. The RBH has a long tradition of providing all levels of care including International referrals. This reflects the high quality of care which is both informed and also directly impacted by the high quality translational research undertaken. The second is that sustained high quality research is a key determinant of the ability of a centre such as the Royal Brompton to retain and recruit the world leading clinical and academic staff on whom its respiratory services depend. Adverse impact upon the ability of the clinical staff to carry out cutting-edge research will undermine the sustainability of the clinical services, to the detriment of its patients. 2/ I am well aware of the letter from the Cystic Fibrosis Trust to you dated 7 October 2011, to which I understand you have not yet responded. I support the contents, namely that the impact upon research at the Royal Brompton Hospital is one which requires careful consideration, and that there should be a full and proper investigation of the potential impact upon respiratory research and CF clinical trials, including Gene Therapy and small molecule treatments for CF, before your committee makes any final decision about changes to children’s cardiac surgery service. I unreservedly support the aims of the review into children’s cardiac surgery, but I urge your committee to ensure that the desired improvements for paediatric cardiac surgery patients do not adversely impact the care of paediatric respiratory patients at the Royal Brompton Hospital and do not impede the potentially life changing research at RBH. Yours faithfully Professor J Stuart Elborn Director, Centre for Infection and Immunity President, European Cystic Fibrosis Association Chair, Research Committee, CF Trust Cc; Dame Sally Davies, Chief Medical Officer, Department of Health Professor Sue Hill, Chief Scientific Officer, Department of Health Mr Robert Bell, Chief Executive, Royal Brompton Hospital Trust Professor Andy Bush, Honorary Consultant Paediatric Chest Physician, Royal Brompton Hospital Trust Mr Matthew Reed, Chief Executive, CF Trust Mr Neil Churchill, Chief Executive, Asthma UK Dr Felix Ratjen, Division Chief of Paediatric Respiratory Medicine, The Hospital for Sick Children, Toronto Chair, PCD Family Support Group Brompton Respiratory Parents