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Many measures have already been put in place to try to ensure that no repetition of the Bristol tragedy ever occurs.

BBC News Online gives a summary of the new systems for monitoring the performance of hospitals and consultant medical staff.

Annual appraisal:

Implementation began April 2001. Negotiated by the British Medical Association, a national system of individual performance review, contractually binding on both consultants and hospital trusts throughout the UK.

Consultants prepare a record of their work, professional development activities, audit and any external assessments for structured discussion with their manager.

National Clinical Assessment Authority:

Started work in April 2001. Will provide a rapid response, including retraining, when doubts about a doctor's performance are raised.

Trusts can ask the agency to investigate cases it cannot handle locally and the Agency will arrange objective peer review.

Not a disciplinary body, but can refer recommendations back to the employing Trust or on to the General Medical Council.

National Patient Safety Agency:

Initial work began March 2001. New, mandatory national system for reporting and preventing accidents and errors in the NHS.

The Agency will identify risks to patient care and disseminate lessons and solutions to the NHS.

Will set national goals for reducing the scope for accident and error in particular procedures.

Commission for Health Improvement:

Established April 2000. Four-yearly rolling programme of visits to health authorities and trusts.

Examines organisational competence, implementation of NICE guidance and has a trouble shooting inspection role.

Not a disciplinary body but can refer serious problems to the NCAA or the GMC.

Can examine the performance of individuals as well as whole Trusts or units.

National Institute for Clinical Excellence:

Established April 2000. Role is to promote best practice through guidance and audit.

Assesses new drugs and treatments and advises on their use within the NHS.

Clinical indicators / league tables:

First published in England in June 1999. Annual publication of performance data from the NHS, including hospital management measures and some clinical indicators including mortality figures.


Proposals from the General Medical Council for a system requiring doctors to demonstrate, on a five yearly basis, that they remain fit to practise.

Proposals currently under discussion. Will require legislation.

Source: British Medical Association

Full coverage of the Bristol heart babies inquiry report

Government response

Key stories

Key figures

Parents' stories

Background briefing


Bristol year by year
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