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Thursday, 17 January, 2002, 15:00 GMT
Bristol action: At a glance
Health Secretary Alan Milburn has published the government's response to the report of the inquiry into the death of children undergoing heart surgery at Bristol Royal Infirmary.

BBC News Online presents a summary of the major points.


Putting patients at the centre of the NHS

  • More information to patients
  • An expert patient programme to support the development of partnerships between clinicians and patients
  • From April 2003, a national knowledge service for the NHS to support the delivery of high quality information for patients and staff
  • Establishment of patient advice and liaison services (PALS) within every trust from April 2002
  • A review of bereavement services
  • Publication of a code of practice on communicating with families about post-mortems in January 2002
  • A reformed NHS complaints procedure by December 2002

    Improving children's health care services

  • A senior member of staff with responsibility for children's services in every strategic health authority, primary care trust (PCT) and NHS trust
  • Paediatric training in an appropriate centre for all staff operating on children
  • Clear standards against which providers of services are inspected as part of the Children's National Service Framework
  • A review by the Paediatric and Congenital Cardiac Services Review of specialist cardiac services for children. It will report in 2002

    Setting, inspecting and monitoring standards of care

  • Setting clear standards through National Institute for Clinical Excellence (Nice) and the national service frameworks
  • NHS bodies being directed to fund treatments recommended by Nice from January 2002
  • Reinforcement of the independence of the Commission for Health Improvement (CHI) in the NHS Reform and Health Care Professions Bill
  • Strengthening of CHI to take on the role of inspection of NHS organisations
  • Swift action where CHI identifies significant problems or where patient safety is compromised
  • The establishment of the Office for Information on Health Care Performance as part of CHI to monitor clinical performance and to publish regular performance indicators on all NHS trusts and PCTs
  • The production of an annual report by CHI on the quality of NHS services which the Secretary of State will lay before parliament

    Ensuring the safety of care

  • Publication of a White Paper in early 2002 to set out plans for reform of dealing with clinical negligence claims
  • The establishment of a single, national system of reporting adverse events and "near misses" through the National Patient Safety Agency (NPSA) during 2002
  • Analysis of the data collected by the NPSA which will feed back lessons quickly to the NHS and elsewhere
  • Strengthened accountability arrangements and supervision responsibilities through job plans for consultants to ensure junior doctors are properly supported and supervised when undertaking new procedures
  • Transfer of responsibility to Nice for providing the oversight and scrutiny needed for the introduction of new interventional procedures
  • Through the consent to treatment initiative, ensuring patients are told when their treatment is of an experimental nature

    Developing a health service which is well led and managed

  • Increase the number of staff - by 2004 there will be: 7,500 more consultants, 2,000 more GPs, 20,000 more nurses and 6,500 more therapists
  • The establishment of the NHS University (NHSU) from 2003
  • The support and development of leaders throughout the NHS by the NHS Modernisation Agency's leadership centre and the NHSU
  • All non-executive and chair appointments to trust boards made by the NHS Appointments Commission
  • An executive director development programme from January 2002
  • An induction guide for non-executive directors to be introduced in 2002
  • Mentors available for NHS trust and PCT chairmen
  • Contract changes which make more explicit the expectations placed on NHS staff by their employing NHS trusts and PCTs
  • Through consultant appraisal, revalidation and re-registration, regular reassessment of professionals' competence both clinically and for any management duties

    Strengthening the regulation and developing the education and training of health care professionals

  • A new council for the regulation of health care professionals to strengthen and co-ordinate the system of professional self-regulation
  • Reform of the current arrangements for the regulation of individual health care professions so that patients will be at the heart of professional regulation
  • Consultation on a new core contract for NHS senior managers and a mandatory code of conduct
  • Wider access to medical schools by 2002 and an increase in the number of places by 2005
  • Greater public involvement in the selection of those entering training as health care professionals
  • A new core curriculum to be introduced during 2002
  • Giving priority to non-clinical aspects of care in the education, training and continuing development of those working in the NHS
  • The establishment of the Medical Education Standards Board to set standards for post-graduate medical education and training
  • Appraisal for all doctors
  • Support for the General Medical Council's (GMC) revalidation for all doctors and encourage its extension to all health care professionals
  • New guidance on disciplinary procedures to support local employers in dealing with breaches of the relevant professional code by a health care professional
  • Support for the National Clinical Assessment Authority (NCAA) to assist NHS trusts and PCTs when concerns about a doctor's practice first arise and before patients are harmed

    Improving information for decision making and strengthening the monitoring of performance

  • The introduction of electronic patient records by 2005
  • Published data on the clinical performance of consultants and their units/teams for use by both clinicians and patients
  • By April 2004, publication of 30-day mortality rates for the previous two years for every cardiac surgeon in England. From April 2005, annual publication on a rolling three-year basis for each centre and for each cardiac surgeon
  • "Star ratings" to compare the performance of NHS organisations against national targets - through the CHI office of information on health care performance from 2002
  • National audits in each of the clinical priority areas of the NHS plan

    Involving patients and the public in health care

  • Establishing, through the NHS Reform and Health Care Professions Bill, patients' forums in every PCT and NHS trust; to be made up of local people
  • Setting up the Commission for Patient and Public Involvement in Health, to set standards and provide training and guidance and build capacity within local communities for greater community involvement
  • Introducing a patient survey programme from 2001 to inform local decision making
  • Requiring every NHS trust and PCT to publish an annual patient prospectus to demonstrate how the public have been involved and the effect of that involvement
  • Establishing a citizens' council to advise Nice on the values inherent in its decisions and guidance on treatments


  • Government response

    Key stories

    Key figures

    Parents' stories

    Background briefing

    Analysis

    Bristol year by year
    See also:

    17 Jan 02 | Health
    Heart surgery deaths made public
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