INQUIRY TEAM PUBLISHES LIST OF MAIN ISSUES

The Bristol Royal Infirmary Inquiry team has today issued for consultation a list of the main themes which will be examined during the first phase of its inquiry into children's heart surgery services at the hospital between 1984 and 1995.

The issues list published today is for phase 1 of the Public Inquiry. This will run from March to December this year and will focus on services which were provided in Bristol.

The second phase of the Inquiry will look at wider issues arising from the Bristol experience and, potentially, affecting the whole of the NHS. An issues list for that second phase will be published later this year.

The document published today sets out the main themes for examination as seen by the Inquiry team. Comments and suggestions for improvements are welcome. The issues have not been placed in any order of priority.

The consultation period is two weeks starting from today. The consultation ends on Friday, January 29.

The Inquiry Chairman, Professor Ian Kennedy, said: "Our terms of reference are very broad and this has been reflected in the draft issues list which we have published for consultation today.

Professor Kennedy said: "As we have said from the beginning, and as people will see from the issues list, we are not seeking to focus on individuals but rather we are looking at the whole system which was responsible for the management of the care of children needing heart surgery services.

He said: "It will not be a court, it will not be a trial. We are not seeking to apportion blame. We are aiming to discover what happened in Bristol, why it happened, and seeing if there are lessons to be learned which will benefit the NHS as a whole.

"We are taking a structured approach which will examine a broad range of themes which follow our terms of reference. At this stage our issues list is a draft and I would welcome and comments people may have or suggestions they might like to make for improvements to what we have set out today.

"I have said that this will be a fair and impartial investigation into the events at the Bristol Royal Infirmary between 1984 and 1995. We have given a commitment to keep people informed about our work and to include as many as possible in what we are doing. I look forward to hearing views on the draft issues list."

The list issued today by the Inquiry team sets out a broad range of themes which include the following areas:

• the national and regional context in which services were delivered;
• the detailed local context - the BRI and its paediatric cardiac surgery unit;
• the type of services provided and the outcomes;
• analysis and comparisons with similar services elsewhere;
• how children were referred to the BRI for treatment;
• management of surgery including pre and post-operative care;
• how families were treated;
• the role of post mortems;
• training of medical and other staff;
• surgical "learning curves" and audit; and
• how and when concerns were expressed and how they were dealt with.

The investigation into the various operations and their outcomes will seek to identify how procedures compared, whether they were better or worse than those elsewhere. The Inquiry team will publish shortly a further note with more detail about how the analysis of the operations will be carried out.

The first phase of the Inquiry will also look at the roles of a variety of organisations, including the medical Royal Colleges, the General Medical Council, British Medical Association, the Department of Health, the Regional Health Authority and other health authorities.

The Inquiry will be looking at a wide range of cases at the BRI including those in which children died or where they suffered permanent disability, such as brain damage.

ENDS

For further information please contact Richard Green, Press Officer, Bristol Royal Infirmary Inquiry, Wellington House, Waterloo Road, London, tel. 0171 972 4325

The Bristol Royal Infirmary Inquiry team has launched an appeal for information from parents whose children had complex heart surgery at the hospital between 1984 and 1995.

The Inquiry is also keen to hear from anyone who may have an interest in the team's work and who would like to make a contribution.

Evidence is being gathered in preparation for the start of full public hearings which are scheduled to begin in March. The latest appeal for information includes newspaper adverts which are appearing in local papers from today.

The Inquiry Chairman, Professor Ian Kennedy, said: "We have already had a good response from a large number of individuals, groups and organisations but we want to make sure that everyone gets a chance to contribute if that is their wish.

Professor Kennedy said: "We have adopted procedures which are fair and impartial and it will assist the Inquiry if we get contributions from as many sources as possible. People may prefer to be represented by a group or organisation but they should also feel free to contact us directly as individuals.

He said: "For some parents, taking part may prove upsetting or difficult and they may choose not to make a contribution. Their wishes will be respected."

For further information please contact Richard Green, Press Officer, Bristol Royal Infirmary Inquiry, Wellington House, Waterloo Road, London, tel. 0171 972 4325.

Notes for editors: Ian Kennedy is Professor of Health Law, Ethics and Policy at the University College, London. He was appointed by Secretary of State for Health Frank Dobson to conduct the Bristol Royal Infirmary Inquiry under Section 84 of the National Health Service Act 1977.

Professor Kennedy's terms of reference are: "To inquire into the management of the care of children receiving complex cardiac surgical services at the Bristol Royal Infirmary between 1984 and 1995 and relevant related issues; to make findings as to the adequacy of the services provided; to establish what action was taken both within and outside the hospital to deal with concerns raised about the surgery and to identify any failure to take appropriate action promptly; to reach conclusions from these events and to make recommendations which could help to secure high quality care across the NHS."

The Inquiry website is: www.Bristol-Inquiry.org.uk/

Thursday, January 7, 1999
BRI 99-01