Health Secretary Alan Milburn has published the government's response to the report of the inquiry into the death of children undergoing heart surgery at Bristol Royal Infirmary. BBC News Online presents a summary of the major points.
Putting patients at the centre of the NHS
More information to patientsAn expert patient programme to support the development of partnerships between clinicians and patientsFrom April 2003, a national knowledge service for the NHS to support the delivery of high quality information for patients and staffEstablishment of patient advice and liaison services (PALS) within every trust from April 2002A review of bereavement servicesPublication of a code of practice on communicating with families about post-mortems in January 2002A reformed NHS complaints procedure by December 2002 Improving children's health care services
A senior member of staff with responsibility for children's services in every strategic health authority, primary care trust (PCT) and NHS trustPaediatric training in an appropriate centre for all staff operating on childrenClear standards against which providers of services are inspected as part of the Children's National Service FrameworkA review by the Paediatric and Congenital Cardiac Services Review of specialist cardiac services for children. It will report in 2002 Setting, inspecting and monitoring standards of care
Setting clear standards through National Institute for Clinical Excellence (Nice) and the national service frameworksNHS bodies being directed to fund treatments recommended by Nice from January 2002Reinforcement of the independence of the Commission for Health Improvement (CHI) in the NHS Reform and Health Care Professions BillStrengthening of CHI to take on the role of inspection of NHS organisationsSwift action where CHI identifies significant problems or where patient safety is compromisedThe establishment of the Office for Information on Health Care Performance as part of CHI to monitor clinical performance and to publish regular performance indicators on all NHS trusts and PCTsThe production of an annual report by CHI on the quality of NHS services which the Secretary of State will lay before parliament Ensuring the safety of care
Publication of a White Paper in early 2002 to set out plans for reform of dealing with clinical negligence claimsThe establishment of a single, national system of reporting adverse events and "near misses" through the National Patient Safety Agency (NPSA) during 2002Analysis of the data collected by the NPSA which will feed back lessons quickly to the NHS and elsewhereStrengthened accountability arrangements and supervision responsibilities through job plans for consultants to ensure junior doctors are properly supported and supervised when undertaking new proceduresTransfer of responsibility to Nice for providing the oversight and scrutiny needed for the introduction of new interventional proceduresThrough the consent to treatment initiative, ensuring patients are told when their treatment is of an experimental nature Developing a health service which is well led and managed
Increase the number of staff - by 2004 there will be: 7,500 more consultants, 2,000 more GPs, 20,000 more nurses and 6,500 more therapistsThe establishment of the NHS University (NHSU) from 2003The support and development of leaders throughout the NHS by the NHS Modernisation Agency's leadership centre and the NHSUAll non-executive and chair appointments to trust boards made by the NHS Appointments CommissionAn executive director development programme from January 2002An induction guide for non-executive directors to be introduced in 2002Mentors available for NHS trust and PCT chairmenContract changes which make more explicit the expectations placed on NHS staff by their employing NHS trusts and PCTsThrough consultant appraisal, revalidation and re-registration, regular reassessment of professionals' competence both clinically and for any management duties Strengthening the regulation and developing the education and training of health care professionals
A new council for the regulation of health care professionals to strengthen and co-ordinate the system of professional self-regulationReform of the current arrangements for the regulation of individual health care professions so that patients will be at the heart of professional regulationConsultation on a new core contract for NHS senior managers and a mandatory code of conductWider access to medical schools by 2002 and an increase in the number of places by 2005Greater public involvement in the selection of those entering training as health care professionalsA new core curriculum to be introduced during 2002Giving priority to non-clinical aspects of care in the education, training and continuing development of those working in the NHSThe establishment of the Medical Education Standards Board to set standards for post-graduate medical education and trainingAppraisal for all doctorsSupport for the General Medical Council's (GMC) revalidation for all doctors and encourage its extension to all health care professionalsNew guidance on disciplinary procedures to support local employers in dealing with breaches of the relevant professional code by a health care professionalSupport for the National Clinical Assessment Authority (NCAA) to assist NHS trusts and PCTs when concerns about a doctor's practice first arise and before patients are harmed Improving information for decision making and strengthening the monitoring of performance
The introduction of electronic patient records by 2005Published data on the clinical performance of consultants and their units/teams for use by both clinicians and patientsBy April 2004, publication of 30-day mortality rates for the previous two years for every cardiac surgeon in England. From April 2005, annual publication on a rolling three-year basis for each centre and for each cardiac surgeon"Star ratings" to compare the performance of NHS organisations against national targets - through the CHI office of information on health care performance from 2002National audits in each of the clinical priority areas of the NHS plan Involving patients and the public in health care
Establishing, through the NHS Reform and Health Care Professions Bill, patients' forums in every PCT and NHS trust; to be made up of local peopleSetting up the Commission for Patient and Public Involvement in Health, to set standards and provide training and guidance and build capacity within local communities for greater community involvementIntroducing a patient survey programme from 2001 to inform local decision makingRequiring every NHS trust and PCT to publish an annual patient prospectus to demonstrate how the public have been involved and the effect of that involvementEstablishing a citizens' council to advise Nice on the values inherent in its decisions and guidance on treatments 
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