November 2015

Independent Review of Children’s Cardiac Surgery in Bristol

In February 2014 Professor Sir Bruce Keogh, Medical Director of NHS England, asked for an independent review of the paediatric cardiac service provided by Bristol Royal Hospital for Children. This followed concerns raised by some families about the quality of care their children received from the Trust.

NHS England published the Terms of Reference for the review, and asked Eleanor Grey QC to lead the Review, with Sir Ian Kennedy acting as a Consultant Advisor.

University Hospitals Bristol NHS Foundation Trust welcomes the review process and is assisting the independent panel with its work.

Frequently Asked Questions

  1. Why is this review being carried out?
  2. What is the review examining?
  3. How far back will the review look?
  4. Who is leading the review?
  5. Is the review relevant to me?
  6. A member of my family is due to be cared for by the children's cardiac services at the Trust, and I have concerns, what can I do? (Who can I speak to at the Trust if I have questions about the care my child will receive?)
  7. My child is a current patient at the Bristol Royal Hospital for Children. Where can I find more information about support for patients and their families?
  8. Does this have implications for other services offered by the Trust?
  9. How long will this review take?
  10. How can I find out about progress with this review?
  11. How can I get involved in the review?
  12. What's the relationship between this review and NHS England's review of Congenital Heart Services?
  13. I have questions for the Independent Review Team – do they also have answers to ‘Frequently Asked Questions’?
  14. I see that the Care Quality Commission (CQC) is currently undertaking a review of children’s cardiac case notes – does this mean that there is a new concern?
  15. Where can I find out more information about Children’s Cardiac Services in Bristol?
  16. Being subject to external Review must put additional pressures on staff. How are you supporting them?
  17. I’m a journalist. How do I contact the Trust for more information?

Questions and Answers

  1. Why is this review being carried out?

This independent review is being carried out at the request of Sir Bruce Keogh, Medical Director of NHS England, following concerns raised by some families about the care provided by our children's cardiac service.

  1. What is the review examining?

The Review has said that they will be exploring four areas in-depth:

  • The environment of care - including staffing, staff skills, record-keeping and communication between staff
  • Communication between the Trust and families
  • The quality of care and compassion provided to families, with a particular focus on what support the Trust offers to families in cases of bereavement
  • The culture of the Trust, including reporting processes, both internally and to relevant regional and national bodies.

In addition to the review being led by Eleanor Grey QC, Sir Mike Richards, Chief Inspector of Hospitals for the Care Quality Commission (CQC) will request the National Institute for Cardiovascular Outcomes Research (NICOR) to carry out further analysis of outcomes after surgery. The CQC will also carry out a clinical case note review. Further details are available in the full Terms of Reference.

  1. How far back will the review look?

The review will include gathering evidence from a range of families about their experiences of Bristol's children's cardiac services since March 2010, when the national standards for children's cardiac surgical services were published. The review team has also said that: “Whilst the Review will primarily examine events from March 2010, it recognises that events leading up to then may also be relevant. Information about earlier events can be submitted, or it can be sought by the Review, which will assess its relevance.”

  1. Who is leading the review?

The review will be led by Eleanor Grey QC, an independent barrister, who was formerly Counsel to the Bristol Royal Infirmary Inquiry. Professor Sir Ian Kennedy will act as Consultant Advisor to the review, for example providing general advice on the gathering of evidence and the review's recommendations. A team of independent expertsmake up the rest of the review team; click here for more details. The review will publish its findings and recommendations, to be considered by NHS England, the Chief Inspector of Hospitals for the Care Quality Commission, and other relevant bodies with responsibilities for the delivery and regulation of services.

  1. Is the review relevant to me?

The review has gathered evidence from a range of families about their experience of Bristol children's cardiac service, primarily since the publication of national standards in March2010, to the date of the review. Further details about the review can be found here.

  1. A member of my family is due to be cared for by the children's cardiac services at the Trust, and I have concerns, what can I do? (Who can I speak to at the Trust if I have questions about the care my child will receive?)

Our expert staff work tirelessly in the interests of every patient, and services continue as normal. The latest available validated data shows that clinical outcomes in Bristol are in line with results from other specialist children's heart centres, with the overall surgical survival rate for children's cardiac procedures at Bristol at 97.3%. The expert clinical staff at Bristol continue to perform highly complex procedures on children and we would like to reassure family members and patients that we are operating a high-quality and safe service at Bristol.

We routinely survey parents whose child has been an inpatient on the cardiac ward. In our most recent survey, 99% said they had received excellent, very good or good care.

If you do have any concerns or questions for staff you can contact

  • Our Cardiology and Cardiac Surgery team on 0117 342 8332, or
  • Our LIAISEservice on telephone number: 0117 3428065 or 0117 3428158, -which provides information, advice, guidance and support around your child's hospital experience, including theMarthaCare worker who is available to offer additional support to families.This may be anything from emotional support to help with practical issues.
  1. My child is a current patient at the Bristol Royal Hospital for Children. Where can I find more information about support for patients and their families?

Information aboutservices which support patients at the Bristol Royal Hospital for Childrencan be foundon the Hospital website, or by clicking onthe links below:

  • Chaplaincy- support for families of all faiths and none
  • Friends for Parents - practical and befriending support for resident parents and families
  • LIAISE- information, advice, guidance and support around your child's hospital experience, including theMarthaCare worker who is available to offer additional support to families.This may be anything from emotional support to help with practical issues.
  • Patient Support Team- Trust wide complaint support and local resolution
  • Hospital Passport- for patients with disabilities and complex needs
  • For information specifically designed for children aged 8 - 12, please visit our children's website.
  • Going to hospital - view the easy read leaflet written for children coming into hospital.
  • If you can't find what you are looking for, please contact the Family Information Room on 0117 342 8065 or email
  1. Does this have implications for other services offered by the Trust?

The Independent Review commissioned by NHS England is focused solely on children's cardiac surgery in Bristol.

  1. How long will this review take?

The Bristol Review team published an update on expected timings for the review on 13th August 2015. The update stated that: ‘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' - The full update can be read here:

  1. How can I find out about progress with this review?

The Trust will be publishing updates about the review when there are significant developments. These will be published here on the Trust website. Information about the review can also be found on their website at

  1. How can I get involved in the review?

The Review has encouraged anyone who believed that they have relevant information about children’s cardiac services in Bristol and its outreach services to make contact with them. This has led to over 250 submissions from families and others. This process of evidence taking closedon 7 September 2015 as the review moves to the next stage. The review team can be reached by: Email: or Tel: 03000 134754

  1. What's the relationship between this review and NHS England's review of Congenital Heart Services?

The independent review led by Eleanor Grey QC is separate to NHS England's national review of congenital heart services. NHS England published the new service standards in July 2015 and they can be found here.University Hospitals Bristol welcomes the publication of the new congenital heart disease standards which set out clear national requirements which the service is confident that it can meet.

  1. I have questions for the Independent Review Team – do they also have answers to ‘Frequently Asked Questions’?

Yes they do. These can be found on their website here.

  1. I see that the Care Quality Commission (CQC) are currently undertaking a review of children’s cardiac case notes – does this mean that there is a new concern?

In their 16/10/15 news update, the Review published an update on the work of the Chief Inspector of Hospitals of the Care Quality Commission (CQC) –They were asked as part of the Review terms of reference back in May 2014 to undertake a review of paediatric cardiac case notes at University Hospitals Bristol NHS Foundation Trust.

A total of 11 case-notesbetween January 2012 and January 2015 have been selected for detailed review, and those families for whom these case notes refer, will be notified directly by the CQC. Once completed, the CQC will publish a report about their overall assessment of the quality of the service. The report will not outline details about the care of individual children. At present, they expect to publish the report in spring of 2016.

  1. Where can I find out more information about Children’s Cardiac Services in Bristol?

If you are a currently under the care of the children’s cardiac team then you will have been provided with a range of information relevant to your particular condition. We also have talked to patients about what they would like to see on our cardiac webpages and as a result these have been updated and extended.

  1. Being subject to external Review must put additional pressures on staff. How are you supporting them?

We understand that in order for us to effectively look after the children and young people in our care, we must take care of our staff. The Trust has put in place a wide range of support mechanisms to ensure that our staff are supported during this period, and continue to remain focussed on delivering exceptional care each and every day.

  1. I’m a journalist. How do I contact the Trust for more information?

Formedia enquiries, please telephone: 0117 342 3629 or 0117 342 3718 during normal office hours (9am to 5.30pm, Monday to Friday). The Trust provides an out-of-hours service for urgent media calls. A member of the Communications team can always be reached via the switchboard on 0117 923 0000.

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