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Bristol Children's hospital may face legal action Bristol Children's hospital may face legal action
(7 months later)
Ten families are seeking legal action against a hospital trust in Bristol, claiming that poor nursing care led to deaths or damage to their children who had been admitted with heart problems.Ten families are seeking legal action against a hospital trust in Bristol, claiming that poor nursing care led to deaths or damage to their children who had been admitted with heart problems.
In an echo of Mid-Staffordshire, where the Francis report last week painted a harrowing picture of poor care, the families complain that nurses on the ward at Bristol Children's hospital on were overstretched and underskilled.In an echo of Mid-Staffordshire, where the Francis report last week painted a harrowing picture of poor care, the families complain that nurses on the ward at Bristol Children's hospital on were overstretched and underskilled.
Alarms that showed children were deteriorating were not answered, they say. Stephen Jenkins, father of Luke, seven, who died of a cardiac arrest last April, a week after heart surgery, says that nurses refused to call consultants, even though he and his partner were shouting for help because they could see their son was dying.Alarms that showed children were deteriorating were not answered, they say. Stephen Jenkins, father of Luke, seven, who died of a cardiac arrest last April, a week after heart surgery, says that nurses refused to call consultants, even though he and his partner were shouting for help because they could see their son was dying.
The cases stretch from 2008 – 2012, and two were not in the cardiac ward, but in the maternity unit. Seven of the children, many of whom were very ill with complex heart problems from birth, died. Three survived but suffered damage.The cases stretch from 2008 – 2012, and two were not in the cardiac ward, but in the maternity unit. Seven of the children, many of whom were very ill with complex heart problems from birth, died. Three survived but suffered damage.
The staffing of ward 32, the children's cardiac ward, has been recognised as an issue. Last October, the Care Quality Commission investigated following complaints from two of the families now seeking legal action.The staffing of ward 32, the children's cardiac ward, has been recognised as an issue. Last October, the Care Quality Commission investigated following complaints from two of the families now seeking legal action.
The NHS care watchdog found that there were insufficient well-qualified nurses for the numbers of patients being treated. It issued a warning notice requiring University Hospitals Bristol NHS Foundation Trust to take immediate action. "I am deeply concerned that some families believe that we have let them down and will continue to ensure that we address their concerns," chief executive of the trust, Robert Woolley, said at the time.The NHS care watchdog found that there were insufficient well-qualified nurses for the numbers of patients being treated. It issued a warning notice requiring University Hospitals Bristol NHS Foundation Trust to take immediate action. "I am deeply concerned that some families believe that we have let them down and will continue to ensure that we address their concerns," chief executive of the trust, Robert Woolley, said at the time.
The trust reduced the numbers of children being admitted to the unit, increasing the nurse-child ratio, and made arrangements for qualified nurses to cover for any who were absent because of sickness. In December, the commission inspected again and said it was satisfied with the new staffing provisions.The trust reduced the numbers of children being admitted to the unit, increasing the nurse-child ratio, and made arrangements for qualified nurses to cover for any who were absent because of sickness. In December, the commission inspected again and said it was satisfied with the new staffing provisions.
The issues in Bristol take on a special significance because it is one of seven hospitals that are to keep their children's heart surgery unit in a reorganisation of care across the country. Three units earmarked for closure – Royal Brompton in London, Glenfield in Leicester and Leeds General Infirmary – have fought hard to stay open. The high court will begin hearing a judicial review on Monday brought by a campaigning group in Leeds, which follows an unsuccessful judicial review brought by the Brompton.The issues in Bristol take on a special significance because it is one of seven hospitals that are to keep their children's heart surgery unit in a reorganisation of care across the country. Three units earmarked for closure – Royal Brompton in London, Glenfield in Leicester and Leeds General Infirmary – have fought hard to stay open. The high court will begin hearing a judicial review on Monday brought by a campaigning group in Leeds, which follows an unsuccessful judicial review brought by the Brompton.
The joint committee of NHS primary care trusts, which has made the decision following the Safe and Sustainable review, argues that closures are essential if high quality care is to be provided to children needing surgery for congenital heart defects. Their numbers are relatively small and the surgery is very complex, so they will receive better treatment in fewer centres where staff are more expert because they operate on more children.The joint committee of NHS primary care trusts, which has made the decision following the Safe and Sustainable review, argues that closures are essential if high quality care is to be provided to children needing surgery for congenital heart defects. Their numbers are relatively small and the surgery is very complex, so they will receive better treatment in fewer centres where staff are more expert because they operate on more children.
The case for change has been accepted since the Bristol babies inquiry under Ian Kennedy more than a decade ago, following deaths at the city's Royal infirmary as a result of its surgeons not having sufficient skills. But the arguments continue as to which hospitals should operate and which should not.The case for change has been accepted since the Bristol babies inquiry under Ian Kennedy more than a decade ago, following deaths at the city's Royal infirmary as a result of its surgeons not having sufficient skills. But the arguments continue as to which hospitals should operate and which should not.
Woolley is confident that the hospital should be one of the seven regional centres and that it can expand its nursing as well as surgical care to take more children. "All paediatric cardiac surgery carries with it significant risk and these risks are explained to parents. Despite these risks and the complex needs of the children we care for, we have results among the best in England," he said in a statement.Woolley is confident that the hospital should be one of the seven regional centres and that it can expand its nursing as well as surgical care to take more children. "All paediatric cardiac surgery carries with it significant risk and these risks are explained to parents. Despite these risks and the complex needs of the children we care for, we have results among the best in England," he said in a statement.
"A comparative outcomes assessment for 2000-2008 undertaken as part of a recent Safe and Sustainable review showed that the Bristol service has the third best mortality rates when mortality rates are compared between the 11 current surgical centres in England."A comparative outcomes assessment for 2000-2008 undertaken as part of a recent Safe and Sustainable review showed that the Bristol service has the third best mortality rates when mortality rates are compared between the 11 current surgical centres in England.
"Mortality figures for 2007-2010 show that the Bristol centre had a 1.6% mortality rate for surgical procedures in the under-one-year age group and 1% in the one to 15-year-old age group.""Mortality figures for 2007-2010 show that the Bristol centre had a 1.6% mortality rate for surgical procedures in the under-one-year age group and 1% in the one to 15-year-old age group."
Laurence Vick, the Exeter solicitor bringing the legal action, who represented many of the original Bristol Royal infirmary cases, said the crucial issue was transparency. "What I'm saying is that they should all publish data," he said.Laurence Vick, the Exeter solicitor bringing the legal action, who represented many of the original Bristol Royal infirmary cases, said the crucial issue was transparency. "What I'm saying is that they should all publish data," he said.
Although adult heart surgeons now publish their individual mortality rates, as was urged by the Kennedy report, the comparative death rates at children's heart units are still not readily available.Although adult heart surgeons now publish their individual mortality rates, as was urged by the Kennedy report, the comparative death rates at children's heart units are still not readily available.
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