Plans to move children’s inpatient services from the Royal Brompton Hospital to the Evelina Children’s hospital

Key points for our community: 

• Guy’s and St Thomas’ have announced that all children’s inpatient and surgical services will be temporarily relocated from the Royal Brompton Hospital (RBH) to the Evelina Children’s Hospital from May 2026 while longer-term arrangements are determined.
• The move is driven primarily by patient safety risks linked to unsustainable paediatric cardiac surgical workforce arrangements beyond April 2026.
• The numbers of children and families affected at any one time are small, vary by specialist pathway, and relate to specialised inpatient care; most children’s care — including outpatient services but not all diagnostics — will continue locally.
• Local health commissioners and providers will always seek to treat North West London children in North West London, where it is clinically appropriate to do so.
• North West London partners support consolidation of paediatric cardiac surgery, but want to clarify the implications for associated respiratory pathways. We are identifying and mitigating key risks and seeking to ensure access and continuity for local children across all affected clinical pathways, during the temporary change period and beyond.

What is happening now?

• We expect a temporary move of some children’s inpatient services and day surgery from the Royal Brompton Hospital to the Evelina Children’s Hospital from May 2026.
• The move has been described as necessary - whilst longer-term arrangements are consulted on - because the clinical drivers behind the relocation of children’s congenital heart disease (CHD) services are pressing.

Services expected to move:

• Children’s cardiac surgery
• Paediatric Intensive Care (PICU)
• Extracorporeal Membrane Oxygenation (ECMO) for children
• Children’s inpatient respiratory care (including cystic fibrosis, severe asthma, long-term ventilation and rare lung disease)
• Associated day-case procedures and diagnostics requiring anaesthetic or sedation

Services not expected to move:

• Children’s heart and lung outpatient clinics (remaining across RBH, Evelina and Harefield)
• Day cases not requiring anaesthetic or sedation
• Outpatient imaging
• Research activity
• Adult services

Why is this happening? 

• National standards introduced in 2017 required certain specialist services —including CHD — to be colocated on one site.
• Plans were developed to consolidate CHD services at the Evelina site following a merger between the Royal Brompton & Harefield and Guy’s & St Thomas’ Trusts.
• Leadership was aligned after the merger in 2021, but estates expansion and funding delays — largely linked to the Covid-19 pandemic — slowed implementation of plans.
• In 2025, Guy’s and St Thomas’ identified that cross-site paediatric cardiac surgical workforce arrangements would not be sustainable beyond April 2026, creating an urgent patient safety concern.

Who is affected — and how?

How many children and families are affected?

• These are specialised tertiary services - they serve children from across London (and beyond).
• Guys and St Thomas’ inform us that approximately 2,500 children use these specialist services each year, of whom approximately 900 are North West London residents.
• The number of children impacted differs by pathway. Only those children who require inpatient admission, surgery and some diagnostics, will be affected by the temporary changes. Children seen primarily as outpatients will continue to receive care in NWL.
• This affects a small number of local children and families, with whom Guy’s and St Thomas’ will communicate directly. 

For local families and patients:

• Most outpatient care is expected to remain local.
• If a child needs inpatient treatment, daycase diagnostics, or surgery from one of the relevant specialties, this would likely take place at the Evelina instead of the Royal Brompton Hospital.
• This has not been confirmed as a permanent change – appraisal of options for the long term and a formal decision making process is expected to follow the temporary move.

Where will services be delivered?

• Inpatient and surgical services: Evelina Children’s Hospital (Westminster Bridge site).
• Outpatient and research activity: Continuing across existing partner sites including RBH and Harefield.

When will this happen?

• Temporary move expected May 2026.
• A formal process to determine the permanent configuration is expected after the temporary change.

What North West London ICB intends to do next

• The formal process is being led by NHSE London region.
• NWL providers and the ICB have identified a number of risks:

o Potential disruption to established patient pathways and clinical collaborations. Local teams rely on RBH support for both secondary and tertiary respiratory services. 

o The RBH PICU currently supports paediatric respiratory emergency pathways. Capacity at Evelina needs to be confirmed given existing pressures.

o Moving the inpatient element of cystic fibrosis care could fragment integrated care and research activity in North West London.

• How this will operate during the temporary period and beyond requires clarification. NWL ICB alongside provider partners intends to:

o Scrutinise the clinical, operational and equality impacts of the temporary changes, including risks to respiratory pathways, emergency care and transition to adult services.

o Engage with NHS England and Guy’s and St Thomas’ on governance, assurance and stakeholder engagement for both the temporary move and the longer-term service configuration.

o Remain actively involved in the NHS England–led process to determine the permanent future model, ensuring that the needs of North West London children and families are fully represented.

• The priority is to ensure clear temporary arrangements and robust longer-term proposals that minimise risk and adverse impact for residents, while maintaining as much care locally as is safe and clinically appropriate.
• The NWL ICB Board endorsed work locally between NWL ICB and its provider partners to temporarily reprovide NWL capacity as needed to maintain pathways and manage risk for local children.
• As such we will establish a locally led project, operating alongside the London work, to identify implications for pathways, activity, workforce and cost. We will adapt our commissioning arrangements and ensure clear communication with families, staff and partners.