RCN calls for lessons to be learned from Bristol review

Review of children's cardiac services criticises unstable nursing leadership and poor nursing numbers.

The RCN has called for all health services across the UK to ‘learn the vital lessons’ contained in an independent review of cardiac services at Bristol Royal Children’s Hospital.

The review, published this week, criticised a lack of nurse leadership and inadequate nursing numbers resulting in a ‘clear risk of harm’.

The Bristol Review, led by Eleanor Grey QC, was set up following concerns raised by parents, including the number of nurses and their skills on a specialist cardiac ward were not adequate to provide proper nursing care to children.

The report investigated cases of children who had been treated at the hospital and gave an overview of paediatric cardiac services between 2010 and 2014.

RCN response

Fiona Smith, RCN professional lead for children and young people’s nursing, said: ‘All health services across the UK need to learn the vital lessons in this report and ensure that they have the right number of registered children's nurses and the right skill mix at all times.

'Effective communication is also paramount. Trust boards must ensure that they pay close attention to those working on the front line, as these are the staff who know the reality of conditions on a ward and of any potential risks on a day-to-day basis.'

The review suggested that the ward in question was under pressure and the ‘inescapable impression was that ward 32 had suffered from the lack of strong and stable leadership for some time’.

It added that nursing numbers would have fallen below ‘recommended levels on a reasonably frequent basis’ and that there was ‘clear risk of harm as a result’.

However, the report found no evidence to suggest there were failures in care and treatment comparable to those identified in a 1998-2001 public inquiry into Bristol Royal Infirmary, which found babies died and others were left brain damaged.

Improvements made

According to University Hospitals Bristol NHS Foundation Trust, the children's heart ward now has one nurse to every three patients, and one for every two children in its high dependency unit.

As a response to the review NHS England has announced it will take action to ensure ‘a consistent level of care’ in cardiac services across the country.

Commissioning changes across England effective from April next year at the latest are due to be published next week.

Further information:

The Bristol review final report



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