As Medical Director for Bristol Royal Hospital for Children, I feel extremely privileged to lead a team of highly skilled and compassionate health professionals delivering highly complex care to hundreds of patients every day. Nowhere is the complexity of the work we do more apparent than in the children’s heart unit, which provides specialist care to children born with congenital heart disease. In 2013/14 we treated more than 900 children, around two-thirds of whom were from the South West: 46 were from Wiltshire. We also work closely with local District General Hospitals in Wiltshire and across the region, whose doctors refer their patients to us to provide expert advice and support.

Children with congenital heart disease may be born with only half a heart, a hole in their heart or sometimes a heart that is back to front.

Sometimes their condition will have been diagnosed in the womb; sometimes only when they are born. These children often require a series of complicated operations within days or hours of birth and then throughout their childhood. It is sometimes hard to imagine the skill and dexterity required by the surgical team to carry out an operation on a heart as small as a walnut. Twenty years ago many children born with such heart conditions would not have survived, however thanks to the huge advances in medicine and surgery we can now give many more, although sadly not all, children the chance of life than ever before. The NHS as a whole is also markedly different to that of 20 years ago; the focus on patient safety and care quality has never been higher. Congenital heart services in England are demonstrably among the best in the world and we have highly sophisticated and robust systems for the reporting and monitoring of outcomes.

Mortality data relating to surgical outcomes is publicly available through the National Institute for Cardiovascular Outcomes Research, which shows that Bristol continuously delivers good results.

Mortality data for children who have undergone heart operations lies entirely within the expected norms when compared to other centres. The Trust also sits in the lowest risk band of the CQC’s new Intelligent Monitoring framework, with no risks showing across any of the 80 or so adult and children’s mortality measures. The recent Safe and Sustainable review, a national NHS review which looked at the best way to improve children's congenital heart services, named Bristol in all four options for centralising children’s heart services into fewer centres, demonstrating support for the service from experts and patients alike.

Feedback from patients and their families about the heart unit at Bristol is consistently positive. In the latest patient survey 99 per cent of parents rated the care they received on the heart unit as good, very good or excellent. However, we are far from complacent and recognise we don’t get it right every time.

We know in a small number of cases families have expressed criticism of the care we provided and called for an independent review to investigate their concerns.

This review has been commissioned by NHS England under the leadership of Eleanor Grey QC, and its terms of reference have recently been announced.

We welcome the review as an opportunity to look closely at our systems and practices to see what we can do better in future. We recognise we have lost the trust of a small number of families and hope the review’s findings will help us better understand how this happened and what we can do to prevent this happening in future. We are also looking to other centres to learn from them: for example, we recently visited Newcastle’s Freeman Hospital, which has an excellent reputation for the care of children with complex heart conditions.

We are also investing in the children’s hospital as a whole to ensure it is equipped to meet the needs of patients in the 21st century. We recently spent £31 million to bring together all specialist children's services, including burns, neurosurgery and orthopaedic units, under one roof in brand new, state of the art facilities. I feel fortunate to do the job I do and to witness every day the amazing work of our highly skilled and dedicated team who put the well-being of each and every child at the centre of their practice. I hope your child never needs our services, but if they do you should have every confidence that they will receive the best care possible, care that is as good as anywhere else in the country. Dr Sean O’ Kelly, Medical Director, University Hospitals Bristol NHS Foundation Trust (including Bristol Royal Hospital for Children).