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Report recommendations at a glance
Major changes could take place in the NHS
The report of the inquiry into the Bristol heart babies scandal has made wide-ranging recommendations for reform of the NHS. These include:

  • Keeping patients informed about care and treatment, with better communication and support.

  • Better consent procedures.

  • A Council for the Quality of Healthcare which brings together the Commission for Health Improvement, the National Institute for Clinical Excellence and the proposed national patient safety agency.

  • Improvements to the management of NHS services.

  • Doctors must keep up to date with clinical practice and must be appraised regularly.

  • Each of the professional bodies, such as the GMC for doctors must continue to oversee professionals, but there should be an overarching body called the Council for the Regulation of healthcare Professionals above them.

  • There must be an environment in which errors can be reported and learnt from.

  • The clinical negligence system should be abolished and in its place should be an alternative system for compensating patients.

  • NICE should co-ordinate all action and monitoring of clinical standards nationally.

  • The Department of Health should not be able to change those standards when it issues other guidance.

  • There must be a coherent set of standards for the NHS, which all bodies must comply with.

  • The Commission for Health Improvement should ensure those standards are met.

  • Assessments should be made public and if a an organisation fails to meet the targets, it should lose its validation to provide care.

  • In time, specialised services, such as children's acute hospital services and children's heart surgery should be included, and be able to show it can deliver all aspects of the service.

  • Information on how trusts, and doctors and services within them, perform compared to others should be available to the public.

  • Trusts should also demonstrate how well they comply with national clinical standards.

  • The public should be more involved in the running of the NHS.


  • A National Director for Children's Services should be appointed.

  • The appointment of a Children's Commissioner for England should be considered.

  • Each NHS body should designate one person as responsible for children's services.

  • The National Service Framework for children's services should be agreed and implemented as "a matter of urgency".

  • Children's healthcare should be provided by specially trained staff.

  • Parents should be more closely involved in planning their children's care.

    Heart surgery

  • National standards for the care of children with congenital heart disease should be developed as a matter of priority.

  • For children's heart surgery, there must be a minimum number of procedures that should take place in order to achieve for good results for children.

  • Surgeons who provide that kind of care should do around four sessions a week to maintain competence.

  • Any unit providing open heart surgery on very young children must have two surgeons trained in paediatric surgery.

  • Children with heart problems should be cared for in specialised children's environment and should be on the same site as a specialised intensive care unit.

  • Extremely specialised operations, performed rarely, should be carried out at a maximum of two units.

  • An investigation should be carried out as a matter of urgency to make sure children's heart services are not currently being carried out "where the low volume of patients or other factors make it unsafe to perform such surgery".
Full coverage of the Bristol heart babies inquiry report

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Bristol year by year
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