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Experts say that the current provision of cardiac services in north and east London have, "relatively poor patient outcomes in comparison to the rest of England", and suggest that St Bartholomew's Hospital in central London should be transformed into a huge cardiovascular surgery unit, and a hub for a comprehensive network of care, which would embrace GPs and local hospitals.
For years, Devi Shetty, world-renowned heart surgeon, philanthropist, Founder, Chairman and Executive Director of Narayana Health, one of Indian’s leading private hospital groups, has argued that, "One hundred or 200 bed hospitals are not the solution". Narayana Health has Asia's largest cardiac centre providing affordable world-class cardiac care. "Large specialist cardiac centres, treating high volumes of patients, staffed by specialists and equipped with the latest technology, save lives, reduce complications, lower costs, and are the hospitals of the future," says Shetty.
In Narayana's 24 hospitals in 23 cities, Shetty has developed a culture of improving clinical outcomes while reducing costs. All Narayana's 14,000 employees are committed to providing affordable world-class integrated healthcare services for people with complex medical needs.
No matter how large the new London cardiac centre, without an outcomes-orientated culture supported by every employee, the quality of patient care is likely to be inferior to that of Narayana Health.
Narayana's surgical outcomes compare well against the world's best. Its mortality rate within 30 days of the high-volume coronary artery bypass surgery is 1.4%, compared with an average of 1.8% for England and 1.9% for the US. Were these figures adjusted for risk, Narayana's outcomes would be even better. Narayana's hospital-acquired infection rate is 2.8% per 1,000 ICU days, which is comparable with the best hospitals in the world.
Typically, Narayana's surgeons work 60 to 70 hours a week, perform up to five operations a day and a third of their compensation is profit related. By contrast, UK's NHS consultant surgeons undertake between three to four procedures a week and their pay is based on 10 4-hour programmed activities a week and anything more is paid overtime. Unlike the NHS, Narayana has no rifts between clinicians and administrators; both are responsible for financial management. Every day, every doctor and every administrator receives a text message with the previous day's profit and loss statement.
Narayana's heart centre in Bangalore is a MECCA for western policy makers. All come away inspired but suggest that Narayana is an “Indian phenomenon”.
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Professor Olaf Wendler
Professor of Cardiac Surgery, King's College London; Chair of the Heart & Vascular Institute, Cleveland Clinic LondonDirectory:
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Professor Wendler is a Consultant Cardiothoracic Surgeon with a specialist internationally accredited interest in Adult Cardiac Surgery. He has been Porfessor of Cardiac Surgery at King's College London since 2012 and is the Chair of the Heart & Vascular Institute at the Cleveland Clinic in London, where he was appointed in 2018.
He qualified, trained and gained substantial experience in Germany before his appointment as Consultant Cardiothoracic Surgeon at King’s College London in 2004. He was Clinical Director for Cardiology and Cardiothoracic Surgery between 2006 and 2012 and promoted Chair of Cardiac Surgery at King's College London in 2012. In June 2012 Professor Wendler was promoted Professor of Cardiac Surgery at King’s College London and since 2013, he is the lead cardiac surgeon in the Clinical Advisory Group of the NHS London Cardiovascular Strategic Clinical Network.
Prof Wendler has a particular surgical and academic interest in arterial coronary bypass surgery, heart valve and aortic root repair, minimally-invasive heart valve surgery, thoracic aortic surgery and repeat and complex cardiac operations. In 2007 Prof Wendler performed the first transapical transcatheter heart valve implantation in the UK, followed by the first implantation in a failing aortic prosthesis (2008) and failing mitral prosthesis (2011).
His special interests are in cardiac surgery, aortic and mitral valve repair, arterial bypass surgery, aortic root surgery, thoracic aortic surgery and transcatheter aortic valve implantation.
A graduate from Hamburg Medical School, Prof Wendler worked as a staff surgeon at the Heart Center Leipzig (Germany) and as a Lead Staff Surgeon in the Cardiothoracic Department of the University Hospital Saarland (Germany). During this time he performed around 2,500 cardiac operations.
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