News


30/06/16

Bristol Review publishes final report

The Independent Review of Children’s Cardiac Services in Bristol has today published its final report. The full report is available to download here.

Commissioned by NHS England Medical Director Sir Bruce Keogh in 2014, and chaired by Eleanor Grey QC, the Bristol Review is an independent review of the safety and quality of children’s cardiac services in Bristol.

Since 2014, the Bristol Review team has been contacted by 237 families whose children were treated at the Bristol Royal Hospital for Children. In addition the team analysed over 6,000 documents from the University Hospitals Bristol NHS Foundation Trust (“the Trust”), NHS England and former commissioning bodies, and held 50 meetings with staff members.

In its report, the Review finds that there was no evidence to suggest that there were failures in care and treatment of the nature that were identified in the Bristol Public Inquiry of 1998-2001. The outcomes of care at the Children’s Hospital were broadly comparable with those of other centres caring for children with congenital heart disease. There was evidence that children and families were well-looked after and were satisfied with the care their children received.

There was, however, also evidence that, on a number of occasions, the care was less good and that parents were let down. The principal focus of the Review was on Ward 32, where children were cared for. It was clear that, particularly prior to the CQC inspection which took place in 2012, the nursing staff were regularly under pressure, both in terms of the numbers available and the range of skills needed. This led on occasions to less than good care for children and poor communication with parents and families.

The Review also reached the conclusion that, on occasions, the senior managers of the Hospital, failed adequately to understand and respond effectively to the concerns of parents and adopted an unnecessarily defensive position in the face of the CQC’s observations. This led to a deeply regrettable breakdown in communication which culminated in the commissioning of this Review.

The Review’s Report makes 32 recommendations, to the University Hospitals Bristol NHS Foundation Trust, NHS England and the Department of Health.

In addition to today’s report, the Review team has compiled expert case reports into the care of 27 children. Each of these cases involved care which raised clinical issues which required expert assistance, and 11 of the reports focused on the care of children who died. A panel of clinical experts have considered these cases in detail and produced a report or letter to the family for each one. The parents of each child who has been the subject of an expert case review have been invited to receive a copy of their child’s report. They have also been offered a private meeting with Eleanor Grey QC, and members of the expert panel who reviewed their child’s care. For those families who would like a meeting, these will take place after publication of the main report from the Review. Some families have asked to wait until this meeting to receive a copy of their child’s expert case review, and the Review team will respect their wishes.

Chair of the Bristol Review, Eleanor Grey QC, said:
“This report is the result of two years of meticulous work. We gathered a vast amount of information from families, staff and experts. I wish to express my gratitude to them for their involvement and co-operation.

“The Review's focus has been on the families who came forward and shared with us their experience of the treatment their children received. Some received good care and had good outcomes. Others did not. Our work has centred on the issues raised by the children whose treatment was complex and who experienced complications, and for whom in many cases the outcomes were poor. I want to express my sincere thanks to all the families, in particular to those for whom recounting their experience was painful.

“We have made 32 recommendations in our report. They require action not just on the part of the Bristol Royal Hospital for Children but also NHS England and the Department of Health.

“I hope and expect that they will be implemented in full, and as swiftly as possible.”

About the Bristol Review
The Bristol Review is an independent review of the safety and quality of children’s cardiac services in Bristol from March 2010 to the date of the Review.  It was established in June 2014 by the NHS Medical Director, Professor Sir Bruce Keogh, and chaired by Eleanor Grey QC. The Review’s work is governed by its Terms of Reference. It has examined the children’s cardiac services provided by the University Hospitals Bristol NHS Foundation Trust in Bristol and at outreach clinics in the South West, as well as in liaison with healthcare services in Wales.

The Review’s Terms of Reference are available here.
Further information about the Expert Case Reviews is available here.
Further information about the Review team is available here.


22/06/16

June update

The report of the Independent Review of Children’s Cardiac Care in Bristol will be published on Thursday 30th June 2016 and will be available to download from this website from that date.

Prior to publication, the Review team has invited those families who have contributed to the Review and who responded to an invitation, to a private briefing on the report from the Chair, Eleanor Grey QC and Professor Sir Ian Kennedy. This briefing is being held twice, once on the Tuesday evening and once during the day on Wednesday. 

On Wednesday, after the meetings with families, there will be a media briefing for journalists. If you are a journalist and wish to confirm your attendance at this briefing please email bristol@luther.co.uk or telephone 020 7618 9116.

In addition to the main report of the Review, the Review team has compiled expert case reports into the care of 27 children. Each of these cases involved care which raised clinical issues which required expert assistance. A panel of clinical experts have considered these cases in detail and produced a report or letter to the family for each one.

The parents of each child who has been the subject of an expert case review have been invited to receive a copy of their child’s report on Monday 27th June. They have also been offered a private meeting with the Chair of the Review, Eleanor Grey QC, and members of the expert panel who reviewed their child’s care. For those families who would like a meeting, these will take place after publication of the main report from the Review. Some families have asked to wait until this meeting to receive a copy of their child’s expert case review, and the Review team will respect their wishes.

Each expert case report ‎contains detailed personal and patient information. It is not the Review’s intention to discuss the contents other than with the families directly and privately, and only if they wish to do so.

Further information about the expert case review process is available here.


11/05/16

Publication update

The report of the Independent Review of Children’s Cardiac Care in Bristol will be published on Thursday 30th June 2016.

All of the families who have contributed to the Review's work have been contacted regarding the process for publication and, where appropriate, how they will receive the expert case report into their child’s care. If you are a family member and have not received any information about publication of the report, we may not have your up to date contact details – please contact the Review team by emailing enquiries@thebristolreview.co.uk or telephoning 03000 134 754 to ensure we have your contact details.

If you are a journalist and would like to attend the media briefing regarding the report, please email bristol@luther.co.uk or telephone 020 7618 9116.


20/04/16

April update

We are now in the process of finalising the expert case review reports and the overall Review report.

We explained in our last update the process of issuing what are called warning letters. We have now completed the process of issuing warning letters.

We expect to complete our report in Spring 2016 and will post further information on timing of publication on our website in the coming weeks.

If any families have changed email address, phone number or address since they contacted the Review we would be grateful if they would get in touch now to let us have their new contact details.

Anyone who has any queries about our work can contact us by emailing enquiries@thebristolreview.co.uk or phoning 03000 134 754.



18/03/16

March update

Our focus over the last month has been on compiling the 27 expert case review reports and drafting our report. It is still possible that during this process we will identify areas where further information is required or that we need to speak to staff further.

During March we will also issue what are called warning letters. The Review team will send a warning letter to any person who may be criticised in the Review’s final report.  If the person wishes to respond to the points in the letter, he or she must do so in writing within 14 days of receiving it, unless a time extension is agreed with the Review.  

A warning letter will set out the criticism or proposed criticism and its basis. No significant or explicit criticism of a person will be included in the Report unless the person has been sent a warning letter and has been given a reasonable opportunity to respond and the Chair of the Review has had an opportunity to consider the representations made.

The existence and contents of any warning letter must be treated as confidential, both by the Review team and by the letter’s recipient unless the Chair of the Review explicitly agrees it may be shared with named other parties. The recipient and any advisor owes that obligation to the Review Team. This obligation ends when the Report is published. 

We said in our last update that we would be contacting all families who have been in touch with the Review to explain the process for publication and to ask if, and how, they would like to receive the report of the Review and the experts’ review of their child’s care, where this has taken place. 

We have begun to send out this communication in the past few days and each family should receive this before 18 March. If you contacted us about your family’s experiences of the Children’s Cardiac Service and have not heard from us by then please do get in touch.

We will also write to the relevant NHS organisations and Welsh Health Specialised Services regarding the publication processes.

All other parties who have provided information to the Review will be able to access the report on the Review website on the day of publication.

All families whose child’s care has undergone expert case review will be offered an individual meeting with members of the Expert Panel shortly after the Report of the Review has been published. We appreciate that this may be a difficult time for families and we can offer access to a counselling service now and at the time of publication of our report.  In line with our Terms of Engagement, we will be sharing the expert case review reports with the Trust.  A copy of the report will also be sent to NHS England who set up the Review.  This is to enable them to take action, as needed, in response to the report’s findings. Both NHS England and the Trust will be required to treat the report as confidential. 

 We cannot at this point in time give an exact date for publication but we still expect to complete our report in Spring 2016 and will post any further information on timing on our website.

We have extended our panel of advisors to include Dr T Biss, Consultant Haematologist at Newcastle upon Tyne Hospitals NHS Foundation Trust.  More information about Dr Biss can be found here.

If any families have changed email address, phone number or address since they contacted the Review we would be grateful if they would get in touch now to let us have their new contact details.

Anyone who has any queries about our work can contact us by emailing enquiries@thebristolreview.co.uk or phoning 03000 134 754.



17/02/16

February update

The main focus of the Review between October and mid February has been meetings with staff from NHS organisations.

We know that families are keen to understand that their concerns and questions are being pursued.  We can offer our assurance that the focus of these discussions has been the issues raised with us by families, together with the issues identified from our review of clinical records for those children where we are undertaking a full expert case review.

To this perspective, we have added the questions we have identified following our review of the substantial volume of documentation we have received from the Trust.

We have now held 56 meetings with staff. Those meetings have resulted, in some cases, in letters seeking further information from those individuals, or from other members of staff.

 We are now at the stage of compiling the 27 expert case review reports and beginning to draft our report. During this process it is possible that we will identify further information is required or that we need to speak to staff further.

 The Expert Panel met on the 12th of January and again on the 9th of February to begin to consider findings and reach agreement on the conclusions from expert case reviews. Further meetings will take place over the coming weeks.

 We cannot at this point in time give an exact date for publication but we still expect to complete our report in Spring 2016 and will post any further information on timing on our website.

 We are also planning to contact all families who have been in touch with the Review, most likely during March, to explain the process for publication and to ask if, and how, they would like to receive the report of the Review and the experts’ review of their child’s care, where this has taken place.

 All families whose child’s care has undergone expert case review will be offered an individual meeting with members of the Expert Panel shortly after the Report of the Review has been published. We appreciate that this may be a difficult time for families and we will be offering access to a counselling service at the time of publication of our report.

If any families have changed email address, phone number or address since they contacted the Review we would be grateful if they would get in touch now to let us have their new contact details.

Anyone who has any queries about our work can contact us by emailing enquiries@thebristolreview.co.uk or phoning 03000 134 754.



 

15/01/16

January update

As we have previously reported our main focus over the last two months has been meetings with staff from NHS organisations. The scope of these meetings has been to discuss, the issues raised with us by families, issues identified from our review of medical records for those children where we are undertaking a full expert case review and questions we have following our review of the substantial volume of documentation we have received from the Trust.

We have now held held 42 meetings and have a further 14 planned between now and early February.

The Expert Panel is continuing its work and a meeting of the Panel will take place on the 12th of January to begin to consider emerging findings and areas for further investigation as a result of our meetings with staff.

Work on drafting our report will commence later this month.

We have extended our panel of advisors to include Mandie Sunderland, Chief Nurse at Nottingham University Hospitals NHS Trust. More information about Mandie can be found here.

Anyone who has any queries about our work can contact us by emailing enquiries@thebristolreview.co.uk or phoning 03000 134 754.


23/11/15

November update

Our main activities over the last month have been analysis of the information we have received from the Trust, commissioners and other interested parties and preparation for meetings with staff from NHS organisations.

We have held 16 meetings as of  20 November 2015 and have a further 27 planned before the year end. A small number of meetings will take place in January 2016.
The Expert Panel is continuing its work which will inform the meetings with clinical staff. 

We have extended our panel of advisors to include Sir Andrew Cash OBE, Chief Executive of Sheffield Teaching Hospitals NHS Foundation Trust. 

Anyone who has any queries about our work can contact us by emailing enquiries@thebristolreview.co.uk or phoning 03000 134 754.


16/10/15

October update

In response to our requests for information we continue to receive further documentation from the Trust, commissioners and other interested parties. In excess of 6000 documents have been received in total and more are still likely to be received.  Our Evidence Team continues to review all the documentary evidence submitted by the Trust and others, to support the work of the Chair and Expert Panel.

The Expert Panel has met on a number of occasions, most recently for two days in September.  They have been reviewing clinical records and other material to consider the issues raised by families in those cases where we are undertaking a full expert case review. We have extended our panel of experts to include a neonatologist, Dr Edile Murdoch from NHS Lothian. 

We have begun interviews with staff from various NHS organisations and the first meetings with Trust staff will take place at the beginning of November.

We have written a detailed protocol for these meetings with staff which can be found on our website here.

We envisage the process of interviews will be completed by mid-January 2016.

Anyone who has any queries about our work can contact us by emailing enquiries@thebristolreview.co.uk or phoning 03000 134 754.

When Sir Bruce Keogh set up the Review it was also agreed that as well as our work, the Chief Inspector of Hospitals of the Care Quality Commission (CQC) would undertake a clinical case note review, to consider the cases of a number of the children who have received care from the service.

CQC have asked us to publish this update about their work:

Care Quality Commission review of paediatric cardiac case notes at University Hospitals Bristol NHS Foundation Trust

The Care Quality Commission monitors, regulates and inspects health and social care services, publishing reports on what we find.  Our role is to make sure patients and service users receive safe, effective, compassionate, high quality care and to encourage services to improve.  Where we identify that services need to improve we take regulatory action to ensure they do.

In response to concerns that have been raised about the paediatric cardiac service at University Hospitals Bristol NHS Foundation Trust the Care Quality Commission is undertaking a review of the case notes of children who have been looked after by the service to assess the quality of care they received.

This review is being undertaken under the powers that the Care Quality Commission has to inspect health services.  It is separate from, The Bristol Review, an independent review of children’s cardiac services in Bristol commissioned by NHS England, although wherever possible we will co-ordinate our review with the work of The Bristol Review.

The Care Quality Commission will review in detail the care provided to a group of children selected from those treated at Bristol between January 2012 and January 2015.  Cases will be selected for detailed review based upon clinical criteria, not because we have specific concerns about the care of any individual child.  Once the detailed review has been completed we will draw on the findings, together with other evidence we have about the service, to publish a report about our overall assessment of the quality of the service.  The report will not outline details about the care of individual children.

The case note review will take place during the autumn of 2015 and, at present, we expect to publish the report in spring of 2016.

If anyone has any queries about CQC’s case note review they should contact: Catherine Campbell (Inspection Manager)by emailing Catherine.Campbell@CQC.org.uk or telephoning 0300 0616161.


10/09/15

September update

Our Secretariat team were very pleased to meet with a number of children and young people on the 15th August. Their experiences of care and treatment add a further dimension to the information we have already received. We extend our thanks to these children and young people and their families for coming to meet us.

We had a telephone discussion with families concerned about our reasons for holding an event for children and young people and the use that would be made of this information. We are always happy to speak to families and other participants and explain what the Review is doing.

Our final call for evidence prompted a number of families to return signed terms of engagement and transcripts of discussions with the Review team. A further 3 families also got in touch with us. Some families have asked for further discussions to answer their questions about the Review and these are being arranged either by face- to-face meetings or by telephone calls.

In response to our requests for information we have received further documentation from the Trust, commissioners and other interested parties, in excess of 1200 further documents have been received. Our Evidence Team continues to review all the documentary evidence submitted by the Trust and others, to support the work of the Chair and Expert Panel.

The expert panel met again on the 21st of August regarding the process of review of individual cases. A further three sessions will take place during September as we begin to prepare for interviews with staff.

During September we will begin the process of making arrangements to meet staff from various NHS organisations and the Trust. The first meetings will take place towards the end of September and we anticipate they will be completed by the end of the year. We have written a detailed protocol for interviews with staff which will be published on the website shortly.

We have begun to plan for publication of our report which will be published directly by the Review on our website. We will give further information about the process for publication and how families and others interested in the Review can receive a copy of the report nearer the time.


13/08/15

August update

Over the last four weeks we have continued to meet with families whose children have received care from the children’s cardiac services in Bristol and gather information from those meetings.

The events for children and young people which we mentioned in our last update will be held on 15th August in the science and discovery centre called At-Bristol. In the morning we are offering a session for 5 to 11 year olds and in the afternoon a session for 12 to 18 year olds. More information can be found here. If you have not yet booked a place please do get in touch as we still have places available. We very much look forward to meeting those of you who are attending.

Since the Review issued the original call for evidence in June 2014, we have received information from 239 families and have met with many of them. We are grateful to all of those families who have contacted the Review and have helped us to build up a detailed picture of their experiences of the Children’s Cardiac Service at Bristol Children’s Hospital.
We are always happy to speak to families and explain what the Review is doing.

The Review is now moving to the next stage of its work, analysing all the information received from families, continuing to investigate the issues arising from that information, and preparing for interviews with Trust staff and others, such as commissioners.

We ask anyone who wants to be involved in the Review, but who hasn’t yet been in touch, to do so before 7th September 2015.  Anyone who still wishes to contact and participate in the Review is still encouraged to do so until this date. Please see here for details of how to do this.

The expert panel met again on the 31st of July regarding the process of review of individual cases. A further meeting will be held in August. We have appointed a further member to our expert panel Elizabeth Leonard. Elizabeth is an experienced senior nurse who has been employed in cardiac nursing at Great Ormond Street Hospital since 1991. More information can be found here.

We have now held three evidence sessions with the Trust.

Our Evidence Team continues to review all the documentary evidence submitted by the Trust and others, to support the work of the Chair and Expert Panel. Further evidence is being requested on a range of issues from the Trust and from commissioners as a result of this analysis.

We anticipate that we will conclude our evidence taking before the end of this year and expect that our report will be completed in Spring 2016.


22/07/15

Statement from Sir Ian Kennedy on the Review’s events for children and young people

A number of families have told us that they are upset by our decision to hold events for children and young people. In light of this, Eleanor Grey and I felt it would be useful to explain why we are holding these events. We want everyone, parents, families, the Trust other interested parties to understand the kind of Review we are conducting.

Families are at the heart of the Review’s work and it is very important that they remain so. The Review is very eager to speak to anyone who is worried about the direction that we are taking. We have been in touch with families who have contacted us about these events, but we are always happy to speak to families and explain what the Review is doing.

The Bristol Review began in response to very serious concerns expressed by a number of families, and our focus is on conducting the thorough, forensic and effective investigation those issues require. In line with our terms of reference, Eleanor and I felt it was right to engage widely and call for evidence from anyone who felt that they had something to contribute to the Review.

To date, 239 families have been in touch, and most have expressed concerns. We have asked for the consent of 26 families to review in detail the treatment of their children. Our avenues of inquiry are driven by the issues raised by families. If we had not engaged widely, some of the issues we will scrutinise in detail might never have come to light.

Eleanor and I believe that a Review looking at services for children and young people in Bristol must hear from children and young people themselves. Parents have told us that their children would like to take part, and it is important that we listen to families.

We will host events that offer a safe and positive opportunity for children and young people to informally express their experiences and feelings about their care and treatment. This process is entirely separate from our investigation of the serious issues raised by families. That scrutiny will be no less exacting or demanding if we also give children and young people the opportunity to raise issues.

Eleanor Grey QC, Chair of the Bristol Review, is on leave for a week and will return on Friday. Sir Ian Kennedy is Consultant Advisor to the Review.


09/07/15

July update

Over the last 4 weeks we have continued to make progress with the activities outlined in our last update.

The expert panel met on the 3rd of July and have begun the process of review of individual cases. A further meeting will be held at the end of July.

I am delighted to be able to report that Dr Michael Rigby has also joined our panel of experts. He is Consultant Paediatric Cardiologist at the Royal Brompton and Harefield NHS Foundation Trust. More information can be found here

We have now have a team of three cardiologists providing expert advice to the Review. There is a great deal of information on which the Review requires expertise from paediatric cardiologists and cardiologists who undertake interventional work. This reflects the pathway of care for children with congenital heart disease where the majority of care and treatment is managed by the paediatric cardiologist.

We will continue to expand the expert panel if necessary in line with our areas of enquiry. The events for children and young people which we mentioned in our last update have now been organised. They will be held on the 15th of August in the at the science and discovery centre called At-Bristol. In the morning we are offering a session for 5-11 year olds and in the afternoon a session for 12 to 18 year olds. More information can be found here.

Our Evidence Team continues to review all the documentary evidence submitted by the Trust and others, to support the work of the Chair and Expert Panel. Further evidence is being requested on a range of issues from the Trust and from NHS England as a result of this analysis.

We have continued to meet with families whose children have received care from the children’s cardiac services in Bristol and gather information from those meetings.

We have held two evidence sessions with the Trust and a third will take place later in July. In due course individual staff interviews will take place informed by the findings from the expert clinical review and our analysis of all of the evidence.

Anyone who wishes to contact and participate in the Review is still encouraged to do so. Please see here for details of how to do this.


09/07/15

Bristol Review hears from children and young people’s experience of heart care

Children and young people will have the opportunity to contribute to the independent review of children’s cardiac services in Bristol at two special events on Saturday the 15th of August. The Review, which was triggered by the concerns of a number of families about the treatment and care received by children born with heart problems, wants to hear directly from children and young people who have used the services to inform its final report.

Eleanor Grey QC, Chair of the Review, said:
“When children and young people are receiving treatment for heart problems, it’s so important that we pay attention to what they think and feel about their care. Some children with heart problems will be under the care of a cardiac centre from the moment they are born until much later in life. Their experiences will help us to understand services at Bristol from their perspective.”

The sessions will be held on Saturday the 15th of August in Bristol at the science and discovery centre, At-Bristol. In the morning from 11am to 1.30pm we are offering a session for 5-11 year olds and in the afternoon from 2pm to 5pm a session for 12 to 18 year olds. The events are designed to provide a comfortable, safe and fun place for children and young people to comment as they wish about any aspect of the care and treatment they have received. There will be facilities for guardians and families to wait while the event is in progress and light refreshments will be provided.

If you or a family member aged between 5 and 18 has had experience of children’s cardiac care at Bristol, and would like to attend the event please contact enquiries@thebristolreview.co.uk to reserve a place.

There are a fixed number of places at the event and places will be allocated on a first-come, first-served basis. 

If any child would like to provide their views but cannot or does not wish to attend the event, or they are now over 18 years of age but received treatment as a child they are welcome to contact enquiries@thebristolreview.co.uk or phone 03000 134 754.


12/06/15

June update

We are pleased to announce that the Bristol Review will shortly move on to the next phase of its work, as our panel of experts begins to review the management of children’s care by the paediatric cardiac service at Bristol, in situations when a child’s care has raised complex clinical issues.

We explained in our last update that we had identified a number of particularly complex examples of care where the Review would like to receive clinical advice upon the management of the children’s care by the paediatric cardiac service at Bristol Children’s Hospital. Over the last month we have received consent from a number of families and the Trust is in the process of collating all the records so we can commence this process.

We have also agreed the methodology for the expert clinical review with our panel. It has been informed by the approach used by the Bristol Royal Infirmary Public Inquiry.

We expect to be able to provide our panel of experts with all the information to begin their first clinical reviews before the end of June. Expert reviews will be based on the information and evidence that families have supplied to us and on the concerns families have raised, as well as other sources.

We have also been advised by the Care Quality Commission that they have commenced the case note review requested by Sir Bruce Keogh and set out in our terms of reference.

I am delighted to be able to report that Professor Ian Murdoch and Dr Frances Bu’Lock have agreed to join our panel of experts. Professor Murdoch is Professor of Paediatric Intensive Care at Guy’s and St Thomas Foundation Trust and Dr Bu’Lock is Consultant Paediatric Cardiologist at the East Midlands Congenital Heart Centre. More information can be found here.

We are planning two events for children and young people to provide the opportunity for them to express their views directly about their care and treatment. The issues we are keen to hear their views about include:

• the quality of the explanations and support made available to them
• how they were enabled to make choices and give their views
• the quality of the physical environment in which they received care
• whether they feel supported to deal with their condition
• what is good or not so good about their experiences overall
• for older children, issues about transition to adult services

More information about these events and how to take part will be available later this month.
Our approach to taking evidence from the Trust and other relevant bodies has been informed and guided by the points raised with us by parents, carers and family members. Our Evidence Team is now reviewing all the documentary evidence submitted by the Trust and others, to support the work of Chair and Expert Panel.

We expect the first evidence session with staff from the Trust to take place before the end of June. The Review will commence this process by seeking responses from the Trust on a series of subjects in line with our terms of reference, including facts about the clinical governance systems in place at the Trust over the period in question and the action taken to implement the recommendations from the Report of the Bristol Royal Infirmary Public Inquiry published in 2001.

In due course individual staff interviews will take place informed by the findings from the expert clinical review and our analysis of all of the evidence.

Anyone who wishes to contact and participate in the Review is still encouraged to do so. Please see here for details of how to do this.


11/05/15

May update

Over the last 2 months we have continued to gather information from families who have contacted the Review.

We have also identified from the information that we have that there are a number of particularly complex cases where the Review would like to receive clinical advice upon the management of the children’s care by the paediatric cardiac service at Bristol Children’s Hospital. We have contacted these families to seek consent for this process to take place. A number of families have already given their consent and we have now begun the process of obtaining all the clinical records and associated information that our expert panel will review. Our experts will also be helping us with some of the broader themes which are set out in our Terms of Reference, and will review other cases as appropriate. More information about the expert clinical review process can be found here.

A second meeting of the expert panel took place on the 24th of April to agree the process for expert case review and plan other aspects of the work to be undertaken in the coming months. The expert panel also visited the Trust on the 24th of April to familiarise themselves with the facilities and services now provided.

The Review Team has been strengthened now that we are in a new phase of our work with the recruitment of an Evidence Manager, Sally Cavanagh and two analysts. They will work alongside the new Review Secretary, Fiona Wood and the Business Manager Lorraine Moseley. Details about these staff can be seen on the website here.

The Review Team is working to support me to take forward the work of the Review. In addition to the expert case review, work is underway on other aspects of the Review process. These include developing the framework against which the management of complaints will be reviewed based on statements from parents, published standards and best practice. The Review Team is also collating information provided by families to enable us to identify information required from the Trust and others to review issues associated with HDU provision and staffing.

The Review Team moved offices in April as the accommodation in Freshford House was no longer available to us. We are now based in One Temple Quay which is convenient for rail and bus transport for those meeting with the Review.

Please do get in touch with the Review if you have any questions or concerns. You can email us at enquiries@thebristolreview.co.uk or call us on 03000 134 754 (calls charged at local rates). If you would prefer to write to us, the Review’s address is now.
The Bristol Review
5th Floor
One Temple Quay
Temple Back East,
Bristol, BS1 6DZ


04/03/15

March update

Since the start of 2015 the Review team has continued to gather information, speaking to many of the families who have contacted the Review so far and drafting formal written accounts of the information they have provided. Over the coming weeks we have further meetings scheduled.

We have held an initial meeting with some of the experts and specialists who we anticipate will be providing advice to the Review. Their advice will help the Review Team to analyse the information which we have been gathering over recent months and to examine the quality of care provided in more detail. We will provide further information about this team shortly.

Further to our last update, some queries have been generated by the fact that we stated that the Review would take note of the conclusions of inquests into the deaths of children who received cardiac services at Bristol. We have added to the FAQs to explain this issue further.

Anyone who wishes to contact and participate in the Review is still encouraged to do so. Please see here for details of how to do this.


22/01/15

January update

Since the last update the Bristol Review team has been in touch with many of the families who have offered to participate in the process to arrange meetings where appropriate, to finalise written accounts or to obtain documentary evidence.

Members of the legal team and the Chair of the Review have also had meetings with some of the families who have contacted the Review. More meetings are scheduled over the coming weeks and the Review team is grateful to all families who have offered to take part, whether or not a meeting is needed at this stage.   We have also been busy drafting written accounts and sending them back to families to be checked, and corrected and added to where necessary. Seeing their information written down as a more formal account has prompted some families to think of additional material that may be relevant to the Review.

Work has been undertaken to finalise the membership of the group of experts and specialists who will be providing advice to the Review. These experts will begin to participate in the Review process over the coming months. They will be advising on the detailed approach that the Review takes to reviewing the information given to it, and also looking in depth at some of the most complex cases. Two inquests into deaths of children who received cardiac services in Bristol have taken place this month. Whilst the Bristol Review is independent of any other organisations or bodies investigating activity at the Hospital, evidence presented to the coroner is a potential source of information for the Review, and the Review team will take note of the conclusions of inquests.  

The Review team is working hard to ensure that the Review is as thorough and comprehensive as possible. With this in mind, we expect the Review to deliver its report to the NHS England Medical Director in late summer 2015.

Anyone who wishes to contact and participate in the Review is still encouraged to do so. Please see here for details of how to do this.

Finally, congratulations to the Consultant Advisor to the Review, Professor Sir Ian Kennedy.  It was announced last week that he is to become an Honorary Queen’s Counsel.


17/12/14

December update from Eleanor Grey QC and Sir Ian Kennedy

Over the holiday period the Bristol Review team will be contactable by telephone or email during normal working hours every day except for Bank Holidays and after 2pm on Christmas Eve and New Year's Eve. We would like to thank everyone who has been in touch with the Review during 2014 and wish you all a Merry Christmas and a Happy New Year.

Over the last two months the Review has been in touch with many of the families who have offered to take part to explain the next step in the process.  In many cases we now have the information we need or just need to check a few details for our records, and  have no further questions at this stage. 

In other cases, we are preparing written accounts of the evidence provided and we will shortly be sending out these written accounts to be checked and confirmed, with questions or requests for additional information where this would be useful. 

Other families have been offered a meeting with a member of our legal team or with the Chair of the Review so that we can explore what we have been told in more depth and in some cases we have asked a group of  clinical experts to offer the Review some additional advice. 

The terms of engagement for people wishing to participate in the Review have now been finalised and are available here.

You may also be interested to know that the report of the Care Quality Commission's recent inspection of the University Hospitals Bristol NHS Foundation Trust was published on 2 December.  Knowing that the Review was underway, the Care Quality Commission included a focus on the children's cardiac service in its inspection.


04/11/14

November update from Eleanor Grey QC and Sir Ian Kennedy

Eleanor Grey QC and Sir Ian Kennedy would like to thank all of the people who have been in touch with the Bristol Review so far. Since we asked for information about people’s experience of the children’s cardiac service at Bristol in July, we have heard from former patients, their families and staff at the cardiac unit.

It is not too late if you haven’t yet been in touch. We are still collecting information and would be very pleased to hear from anyone who believes they have relevant information.

We will be contacting everyone who has been in touch with us over the next month. In our letters, we may ask for more information, we may ask if you would like to meet with the Review staff, or we may simply thank you for the information you have supplied. If you have contacted the Review but do not receive a letter from us in the next month, do not worry, but get in touch with the Review on enquiries@thebristolreview.co.uk or 03000 134 754 (calls charged at local rates).

Since our last update, the Review has set up an office in Bristol, which we are using to review the information we have received and to hold meetings. This also means we have a new telephone number, 03000 134 754, which should be used for any questions or concerns about the Review. We have also visited the cardiac unit at Bristol Children’s Hospital, and we continue to obtain information from University Hospitals Bristol NHS Foundation Trust. We are also setting up a panel of experts to help us assess some of the information we have received.

The Review now has a good idea of the information it is likely to need to carry out its work and how long the process will take. We cannot predict exactly when the Review will report because we will be led by the evidence. On the basis of the information we have received so far, however, we now expect that the Review will deliver its report to the NHS England Medical Director in the summer of 2015, and will aim to close its work in the autumn.

Please do get in touch with the Review if you have any questions or concerns. You can email us at enquiries@thebristolreview.co.uk or call us on 03000 134 754 (calls charged at local rates). If you would prefer to write to us, the Review’s address is:

The Bristol Review
2nd Floor
Freshford House
Redcliffe Way
Bristol
BS1 6NL


01/08/14

120 offer views to Bristol children's heart services review; invitation to give evidence is still open

More than 120 potential witnesses have contacted the Independent Review of children’s cardiac services at the Bristol Children’s Hospital since its launch last month. 
 
The review team thanks everyone who has responded so far, but is still keen to hear from anyone who can provide information.

The invitation is open to any patient, or family member of a patient who was treated by the children’s cardiac service at Bristol since March 2010. The review is equally keen to hear from members of staff.

Former patients, their family members. and anyone else who feels they can help should read and fill in the form here. Staff members should use the form here.

If you think you could help, but you’re not sure how to proceed, or you would like further information about the Review and how to give evidence, please contact us  by emailing enquiries@thebristolreview.co.uk or telephone 020 7618 9116.


29/07/14

Have you received a letter from the Independent Review of children’s cardiac services at the Bristol Children’s Hospital?

You may have received a letter from the Review’s Chair in the past few days, asking for information about children’s cardiac services at Bristol. The letters were sent out to former patients or their families by the University Hospitals Bristol NHS Foundation Trust, as the Trust is able to contact patients or former patients. 

The  Review is keen to receive evidence from anyone who believes they have relevant information. 

If you or a member of your family were treated by the children’s cardiac service at Bristol since March 2010, or you feel that you have relevant information and would like to submit evidence, please read and fill in the form here. There is a separate form for members of hospital staff here.

If you received this letter but were treated for heart disease when you were an adult, University Hospitals Bristol NHS Foundation Trust has contacted you in error. Please accept our apologies and the apologies of the Trust. You need take no further action.

 


23/06/14

Independent Review of Children’s Cardiac Services in Bristol

NHS England has published terms of reference for the review into children’s cardiac services in Bristol. The review was triggered by the concerns of a number of families whose children have died at the hospital and the terms of reference have been drawn up following discussions with them.

It is led by Eleanor Grey QC, an independent barrister and former Counsel to the Bristol Royal Infirmary Public Inquiry. Sir Ian Kennedy, the former chairman of the Bristol public inquiry, is consultant advisor.

Eleanor Grey QC said:
“I am looking forward to conducting the review. Our first tasks are to outline our approach and start the process of gathering evidence.  To that end, we encourage everyone with relevant experience of children’s heart services at Bristol, particularly families and hospital staff, to help the Inquiry by submitting their evidence. We will be thorough and robust, and will seek to complete our task with all due speed.”

Sir Ian Kennedy said:
“I am returning to Bristol to support Eleanor Grey in this review thirteen years after the publication of the Bristol Inquiry.  Every family has a right to expect safe, high quality and compassionate care for their child.  We must hear the evidence, identify any shortcomings in care, and set out any measures necessary to improve the children and families’ experience of cardiac care.”

Media enquiries should be directed to bristol@luther.co.uk and 020 7618 9116