Update on Cardiac Cath Lab service at St Richard’s Hospital, in Chichester 

During a routine inspection in January 2025, a significant issue was identified with the high-tech air exchange ventilation system required for safe use of the theatre. 

Immediate action was taken, and use of the Cath Lab was paused while the staff worked hard to find a solution that ensured there was no disruption for patients. 

Since this time, the hospital’s Interventional Radiology Suite has been used to continue providing Pacing procedures for around 300 patients a year. 

Earlier in the year, our clinicians reviewed a wide range of options for providing this service and we are now carrying out a comprehensive strategic review of two of these: whether to renovate the Cath Lab or relocate the service to Worthing Hospital. 

No. The Cath Lab at St Richard’s was only open three days a week and did not provide out of hours or emergency care. 

Patients requiring complex or emergency Cath Lab care are treated at other hospitals in Portsmouth, Worthing and Brighton.  

No. This review is strictly focused on non-complex Cath Lab procedures and potentially affects around 300 patients a year who currently receive care at St Richard’s. 

There is no change to urgent or emergency heart attack pathways: 

• Heart Attacks (STEMI): Patients with life-threatening emergencies will continue to be blue-lighted by ambulance to the regional Heart Attack Centres in Portsmouth or Brighton, 24 hours a day. 

St Richard’s Services: The Acute Cardiology Ward and all Cardiology Outpatient Services at St Richard’s Hospital are not changing or part of our review. 

Around 300 patients a year have a Pacing procedure at St Richard’s. This service has continued to take place at St Richard’s in the Interventional Radiology Suite. 

Only 15 patients have been transferred to Worthing Hospital since January 2025 to receive their treatment at the Cath Labs there. 

The single Cath Lab at St Richard’s is only used for Pacing, which accounts for a minority of procedures that take place in Cath Labs. 

Around 70% of people in the Chichester area who need Cath Lab care already travel further away to other hospitals with two Cath Labs where they can receive a broader range of procedures and more complex care. 

Significant work is required to fix the issue and reopen it for patients. We have been advised the work would take between 18 and 24 months and cost around £2 million. 

Before committing public money to fix the lab, we need to ensure this is the right thing to do for all our patients, both now and for the next 20 years. 

Recent changes to clinical guidance and recommendations have restricted the Cath Lab’s use at St Richard’s, which meant it was only open three days a week. 

This is why we are carrying out a clinically led strategic review to assess our options.  

A Cardiac Catheterisation Laboratory is a high-tech theatre where cardiologists perform minimally invasive procedures on a patient’s heart guided by x-rays.  

Most people call it a Cath Lab. 

Patients are usually awake during their procedure and cared for by a team of different specialists, including a nurse, radiographer, and cardiac physiologist, led by a consultant cardiologist. 

Cath Labs are used for a variety of procedures to diagnose and treat problems with the heart, including coronary artery disease, heart rhythm problems and valve disorders.  

Cath Labs often enable doctors to treat heart disease without the need for major open-heart surgery. 

Hospitals with two Cath Labs or more offer both the largest proportion, and biggest range of procedures. These include:  

• Coronary Angioplasty and Stenting (PCI) 
• Ablation 
• Pacing, including CRT and implantable defibrillators (ICDs) 

Cardiac surgical centres provide more complex interventions, including: 

• Valve intervention: Transcatheter Aortic Valve Implantation (TAVI) and mitral valve intervention 
• Complex ablation 
• Pacemaker lead extraction 

Single-sited Cath Labs are more restricted in what procedures they can offer to patients, including: 

• Pacing procedures 
• Simple ablation procedures 

At University Hospitals Sussex, we have seven Cath Labs in our hospitals. 

• St Richard’s Hospital – one 

• Worthing Hospital – two 

• Royal Sussex County Hospital – four 

Before its closure, the St Richard’s Cath Lab was open three days a week and never overnight or at weekends.  

Our Worthing Cath Labs currently operate five days a week and provide a broader range of more complex Cath Lab procedures. 

Our Cath Lab service in Brighton is available 24 hours a day, seven days a week, as the Royal Sussex County Hospital is a heart attack centre and specialist tertiary centre for cardiac surgery. 

The use of Single Cath Labs is restricted following changes to clinical guidance and how cardiology services have been reorganised nationally. 

1. Heart Attack Centres 

Around 20 years ago, a national network of Heart Attack Centres (HACs) was established to offer critical life-saving interventions 24 hours a day, seven days a week. 

Our local centres are Queen Alexandra Hospital in Portsmouth and Royal Sussex County Hospital in Brighton.  

Suspected heart attack patients are always blue-lighted by ambulance to these centres. 

2. Complex Cath Lab care 

Guidance now states more complex cardiac care needs to take place at hospitals with at least two Cath Labs and support from 24/7 critical care and emergency surgical services.  

This means patients with urgent or more complex cardiac conditions from the Chichester area currently travel to Portsmouth, Worthing or Brighton for treatment. 

Around 70% of cardiology patients from the Chichester area who need Cath Lab care travel to hospitals further away than St Richard’s for their treatment.  

3. Clinical shift from single-site labs 

In recent years, there has been a national shift away from single-sited Cath Labs, driven by several factors, including: 

• Safety 
• Service resilience 
• Staffing 
• Changes to diagnostic processes 

Guidance now states hospitals should have access to a second Cath Lab. This improves patient safety during complications and strengthens the resilience of the service at other times. 

The Cath Lab at St Richard’s Hospital was historically used for Angiography, which has now largely been replaced by CT scanning as this is less invasive for patients.  

With the closure of the Cath Lab at St Richard’s, Angiography procedures were stopped. To comply with guidance from NHS England and the British Cardiovascular Intervention Society, these will not restart in the future. 

The use of the single Cath Lab at St Richard’s Hospital is restricted to Pacing and Simple Ablation procedures. 

Our strategic review is led by clinicians sitting on a multi-disciplinary Steering Group, ensuring clinical expertise, operational experience, and the St Richard’s perspective are all integral to the process. 

The group draws upon extensive expertise from the trust’s Cardiology and Cardiac Surgery service. The following specialty clinical leaders sit on the Steering Group:  

• Clinical Director 
• Clinical Lead 
• Head of Nursing
• Matron 
• Cath Lab Sister 
• Consultant cardiologists 

The governance structure is designed to ensure our appraisal is based on frontline reality and clinical necessity, as well as strategic oversight.  

We sent a survey to all patients who used our Cath Lab service at St Richard’s and Worthing hospitals in 2024 and 2025. 

We received 259 completed surveys from 1,400 sent out in November, ensuring a robust and reliable sample size from which to draw reliable insight. 

The survey’s design focused on understanding the difference in experience between sites, the demographic profiles of patients, and their priorities for service provision. 

The results provided us with important patient voice feedback that is directly informing our strategic review, risk analysis, and mitigation process. 

Quality is overwhelmingly the number one priority for our patients in planning a new Cath Lab service. This is followed by Short Waiting Times and Short Travel Time. 

Statistical analysis shows that shorter travel time is ranked so much lower that patients have a willingness to potentially travel further if it guarantees the highest quality care. 

However, our Cath Lab patients are often elderly, and many have a disability. This is why access and travel are very important factors in our options appraisal. 

78% of patients attended their procedure in a private vehicle (either driving themselves or being driven), highlighting the importance of parking and manageable travel distance. 

Importantly, there was no statistically significant difference in patient scores against most criteria and all clinical quality measures between Worthing and St Richard’s, which shows both hospital teams offer a high standard of clinical care. 

This helps us focus our appraisal on resilience and efficiency, as factors that underpin quality of care and experience for our patients. 

In July, our Clinical Transformation Programme Board reviewed a long list of potential options. It advised two options should be reviewed in detail by a clinically led steering group. The group is assessing two Renovate vs Relocate options. 

We are following a thorough process and do not expect confirmation of a preferred option until at least February 2026. 

When the work of the steering group is finished it will be reviewed by our Clinical Transformation Programme Board, which includes the Trust’s leading clinicians. 

There will also be a detailed financial jurisprudence assessment to ensure any proposed use of taxpayer funds provides the best value for patients and the NHS. 

In addition, we have commissioned an expert review from a nationally renowned consultant cardiologist from the Oxford Heart Centre and Clinical Director of the Internal Medicine Clinical Network, NHS England South East. 

Following the independent expert review, we will be able to share a preferred option with the public, media and stakeholders. 

We know St Richard’s Hospital is a hugely valued community asset and we recognise the community’s concern about changes to their local hospital. 

It is important to stress that we are only looking at the non-complex Cath Lab service, which currently provides treatment to around 300 patients a year. 

Emergency Care, the Acute Cardiology Ward and Cardiology Outpatients Service are unaffected – we have no plans to change these important services for local people. 

Before spending £2 million on a 2-year capital programme to fix a currently under-used asset, we have a public duty to ensure this is the best use of our limited funds. 

We have a responsibility to make sure our decision takes account of changes to clinical guidance, which have restricted the use of the single Cath Lab at St Richard’s. 

Around 70% of people living in the Chichester area who need a Cath Lab procedure currently travel to other hospitals with more than one lab for their treatment.

Hospitals with at least two Cath Labs, such as Worthing Hospital, are able to offer more procedures and provide the majority of Cath Lab care for our patients.

There is not the local demand in the Chichester area to use a single Cath Lab five days a week, and so there is no justification to consider having two Cath Labs at St Richard’s. 

We are carefully considering a significant amount of data, such as future trends for Cath Lab care, to ensure Worthing could have the capacity for 300 more patients a year if this is the preferred option.  

This is why we are carrying out a thorough strategic review process to determine what option is best for our patients, now and for the next 20 years. 

St Richard’s Hospital is a vital member of the University Hospitals Sussex family of seven hospitals in Sussex, and we have no plans to change this. 

In fact, over the next ten years, we will be spending more money on St Richard’s Hospital than any of our other hospitals. 

In October, BBC News featured the official opening of our new £6 million Same Day Emergency Care unit.

We are about to start a multi-million programme to completely redevelop our diagnostic block which contains our Pathology, Pharmacy and Radiology services. 

In 2027, our stroke service at Worthing Hospital will transfer to St Richard’s when our brand new state-of-the-art Acute Stroke Centre opens in Chichester to offer 24/7 emergency and specialist stroke for people living across West Sussex. 

We are committed to improving all our hospitals in Sussex. For more information, please see our new Trust Strategy (October 2025).