Welcome.....
.....to the ninth edition of Inquiry News. This issue contains new information
about the conclusion of Phase one evidence, about Phase Two and about
statistical analysis feedback and the clinical case note review findings.
There is also information about the Inquiry’s Website (www.bristol-inquiry.org.uk/)
which now includes written comments from clinicians regarding their referral
practice for babies and children with complex congenital heart defects.
We have had many requests for a full timetable of witnesses for the rest
of Phase One, so in this issue on page 6 we have included the winter schedule
up to 16 December, although this may be subject to last minute changes.
If there is anything you would like to see in Inquiry News or if you
would like further information on any topic then please contact Becky
Jarvis, Media Relations Manager on 0117 938 8716 or e-mail R.Jarvis@bri-inq.org.uk.
Witness Statements
The Inquiry has so far received 339 witness statements and 226 comments
on those statements. 148 of the statements have been from families, and
more are continuing to come in.
We have heard from almost 100 witnesses as well as Independent Experts
at the Oral Hearings . There have been 75 days of Hearings which amounts
to more than 275 hours of oral evidence.
Evidence scanned into the Inquiry’s computer database consists of
almost 850,000 pages. That is 674,000 pages of medical documents and 175,000
of other evidence.
THE CONCLUSION OF PHASE ONE ORAL EVIDENCE
1. Phase One hearings will conclude on Thursday 16th December.
2. Thereafter, and in accordance with the Chairman’s Opening Statement,
those witnesses who choose to do so, by themselves or through their legal
representatives, may make a short final presentation in writing or, at
the discretion of the Chairman, orally. Any witness who has given oral
evidence to the Inquiry in Phase One may put in a short final presentation.
These presentations must be received by Friday 21st January 2000.
3. Any witness who submits such a presentation and who wishes, additionally,
to make an oral presentation to the Inquiry should inform the Solicitor
to the Inquiry in writing at the time of submitting the written presentation.
4. Such requests will be put before the Chairman for consideration. Those
from whom the Chairman considers it would assist the Inquiry to hear orally
will be informed by Friday 28th January and invited to make their oral
presentation on 9th or 10th February.
5. The Inquiry Panel will reconvene in Bristol for the final oral presentations
of Phase One on 9th and 10th February 2000.
6. All written presentations, whether or not oral presentation has been
invited, will be made public prior to 9th February.
7. The length of the oral presentations will be time limited by the Chairman.
Phase Two
Whilst most people are planning no further ahead than Christmas and the
Millennium, the Inquiry is already well advanced with its plans for Phase
Two, to take place during the first few months of 2000.
During the Summer we distributed a consultation note about Phase Two
issues to which there were many responses. The purpose of this second
stage of the Inquiry will be to examine wider issues emerging from Phase
One, it gives the Panel an opportunity to stand back and look at the NHS
in a broader perspective and focus its attention on the future.
The objectives of Phase Two are to assist the Inquiry Panel to meet the
requirement in their Terms of Reference to "make recommendations
which could help to secure high quality care across the NHS"; and
to ensure that recommendations are "relevant to the NHS of the future,
practical, achievable and within a realistic level of resources."
The first step will be for the Inquiry to commission "position papers",
papers that express views about the themes of Phase Two, from a wide range
of organisations and individuals who have an important contribution to
make in certain areas. Further short papers will be commissioned from
some of those individuals invited to attend the seminars.
The papers will be published and will be supplemented by, and used to
inform, the debate at a series of public seminars.
There will be a number of seminars held during January, February and
March 2000, each one concentrating on a different theme. They will take
the form of a round table discussion with a variety of participants and
will be held over the course of a day, split into two sessions, morning
and afternoon.
The theme of each seminar will be broken down into topics. Some of those
attending will be asked to submit points for discussion.
The approach will be wide-ranging and will challenge conventional ways
of thinking about the NHS.
Participation in the seminars is by invitation only; the seminars are
open to the press and public to attend.
However, as places are limited at all the venues, due to space considerations,
anyone who wishes to attend is requested to inform the Inquiry in writing.
More details of dates, times and specific seminar topics will be published
during November.
Support and Counselling at the Inquiry
Inquiry staff are always available to help anyone who attends the Inquiry
and can provide information and immediate support. In addition, we have
made particular arrangements to ensure that during each hearing day in
November and December, a professional counsellor will be available at
the Inquiry premises to provide support and counselling as necessary.
We have also made several practical arrangements which we hope will go
some way to ensure that the process of following the Inquiry’s proceedings
are as easy as possible.
In the waiting area of the Inquiry premises there is a room set aside
as a quiet room and there is also a family room. These are available to
anyone who visits the Inquiry and who wishes to take a break from the
hearing chamber. It is also possible to follow the hearing on TV screens
here at the premises of the Inquiry if anyone feels uncomfortable sitting
in the hearing chamber itself.
Longer term support and counselling is a service which needs to be tailored
to the needs of each individual. Therefore, it is not something that it
would be appropriate for the Inquiry to seek to provide. We are only here
for a limited time and the needs of individuals for counselling and support
may continue long after the Inquiry has completed its work. We will, however,
do whatever we can to assist any family or individual who seeks our help
to make contact with appropriate statutory or voluntary counselling services.
The Inquiry leaflet on support and assistance contains useful information
and staff will continue to provide further information and, if necessary,
help in making contact with local services as requests for assistance
are made to us.
Independent Counselling and Advice Services
Also, for four weeks from 28 October the Inquiry has arranged for the
ICAS (Independent Counselling and Advice Services) National Support Centre
to provide confidential, independent telephone counselling support to
those parents who have received the clinical case notes review report
on their child. The service is available 24 hours per day on freephone
0800 316 0130.
The counsellors staffing this help line are fully briefed for these calls
and will ask "which organisation are you calling from", you
may remain anonymous but will be required to tell the counsellor that
you have been given the number by the Bristol Royal Infirmary Public Inquiry.
Clinical Case Note Review Completed
The Bristol Royal Infirmary Inquiry announced in August 1999 its proposals
to review a sample of cases taken from over 1,800 children and babies
who received either open or closed heart surgery over a 12-year period.
It is the first time that a sample of cases, drawn from virtually all
the paediatric cardiac activity at the Bristol Royal Infirmary and Bristol
Children’s Hospital between 1984 and 1995, has been so thoroughly
reviewed.
The exercise has been carried out by teams of Independent experts with
a wide range of clinical, academic and managerial experience.
The clinicians on the Inquiry’s Expert Group were formed into review
teams, which consist of five members:
paediatric cardiac surgeon;
· paediatric cardiologist;
· paediatric anaesthetist/intensivist;
· paediatric pathologist; and
· paediatric nurse or intensive care nurse.
The review is an important contribution to the Inquiry’s understanding
of the adequacy of the services at the BRI and Children’s Hospital
although it is only one of a number of sources of evidence on adequacy.
The Inquiry has made extensive efforts to contact all families in the
sample to ask for their views and comments; no personally identifiable
information about any individual will be made public without a family’s
prior permission.
Review teams have looked at the adequacy of key aspects of pre-operative,
surgical and post-operative care, as well as the adequacy of care overall.
Feedback from the review was given to Inquiry at the beginning of November.
Transcripts and a summary of the review teams’ conclusions are published
on the Inquiry’s website at www.bristol-inquiry.org.uk/brisClinCase.htm
and copies have been sent to libraries and community health councils.
Data Source Analysis
Statistical review, analysis and synthesis of six key data sources relevant
to the work of the Inquiry has now been completed and its results are
available.
This is part of the exploratory phase of the Inquiry’s strategy
for using statistics to inform its investigation of children’s heart
surgery at Bristol.
Two of the data sources identified by the Inquiry, Hospital Episode Statistics
and the UK Cardiac Surgical Register are national in scope and enable
comparisons to be made between Bristol and other centres. Information
contained in two further sources, patients’ clinical records and
surgeons’ logs, has been transferred to new computer databases for
analysis. The other two key sources are the South West Congenital Heart
Register and the United Bristol Healthcare NHS Trust’s Patient Administration
System (PAS).
The Inquiry published a paper containing a preliminary overview of the
strengths, weaknesses and limitations of these sources in July 1999. That
paper is published on the Inquiry’s website: www.bristol-inquiry.org.uk/brisDSAnalysis.htm
The oral hearings of the Inquiry are open to anyone to attend and we
have provided a number of facilities in order to make visits to the Inquiry
as comfortable as possible.
All facilities intended for public use are located on the fifth floor.
We have several rooms which may be used for meetings with family members
or legal advisers. In order to book a room please contact the Inquiry
switchboard on 0117 938 8700.
If you have young children with you, you may wish to use Room 1 where
it is possible to follow the hearing on TV screens. The family room (Room
4) has a TV and video for public use and there is an area with a microwave
and fridge intended for use by people with young children.
The Inquiry facilities do not, unfortunately, enable us to provide a
crèche; we have tried to do our best therefore, to provide facilities
where parents and carers can look after children in their care. Children
under 16 must remain with an adult member of their family, or a family
appointed carer at all times.
There is a ramp to the rear of the building and there is a designated
area within the Inquiry Chamber for use by wheelchair users. Unfortunately,
there are no car parking facilities at the Inquiry. However, if you contact
the Inquiry switchboard number prior to attending the Inquiry we will
be able to advise you about leaving and collecting people from the building.
There is a FAX machine available in Reception (0117 938 8788) and a photocopier.
There is also a public telephone for outgoing calls only.
Snacks and drinks are available from vending machines in the waiting
area and there is also an area for the preparation of refreshments for
children. If you want a lunch time meal then we advise using the many
restaurants and bars available in the nearby Bristol City Centre. No food
or drink must be taken into the Hearing Chamber. Room 3 on the fifth floor
has been designated a smoking room.
There will be no broadcasting, either audio or visual, nor any photography
allowed while proceedings are underway. On occasions, with prior agreement
of Inquiry staff, the media will be given opportunities to film and take
photographs within the Inquiry chamber. This will only be at times when
evidence is not being taken. There is a room next to the reception area,
which is available for media interviews.
A Duty Manager is available at all times while the Inquiry is sitting.
Should you wish to contact him/her, please ask at reception.
Inquiry Website
The number of visitors to the Inquiry Website has reached 450,000. People
from all over the world are logging in from as far afield as Botswana
and Brazil.
There has been a significant increase in the number of hits following
the start of the oral hearings in March. Most popular pages are the daily
transcripts and witness statements. The busiest day was 3rd November with
over 3,000 people logging in from 60 different countries.
Several new sections have been added to the website including, "Phase
Two", "Data Source Analysis" and "Clinical Case Review".
If you haven’t visited the Inquiry website yet, here is the address:
www.bristol-inquiry.org.uk/
Hearing Schedule
The Winter Schedule, as announced earlier this month, can be found in
the November News Releases section. It has been necessary to schedule
these witneses this far in advance in order to accommodate those with
clinical commitments or those who may be required to attend for more than
one day. It does not include some other witnesses who it may be necessary
to call, such as parents. Any changes to the schedule will be publicised
by the Inquiry.
This hearing schedule may be subject to some minor changes, please check
local press or the Inquiry website in advance of travelling. Alternatively,
you can call Rachel Gibbons, Communications Officer on 0117 938 8711.
The hearings are open to anyone to attend, see page 5 for details of the
facilities provided.
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