The impact of the Bristol Royal Infirmary disaster and inquiry on public services in the UK.

The inquiry into the services provided by the paediatric cardiac surgical team at Bristol Royal Infirmary between 1984 and 1995 marks a watershed in the development of health and social care services in the UK. There was an organisational failure of foresight based on a series of systemic and communication failures which contributed to oversight of an 'incubating' hazard which ultimately led to disaster. The recommendations of the Bristol inquiry have provided a major stimulus to the modernisation programme and especially of governance in health and social care which aims to restore public confidence and create 'high-trust' organisations. While it is premature to evaluate the impact of the changes, there is little evidence at present to indicate that they will improve the quality of professional decision making and the safety of users or enhance user and public confidence in the NHS and other public services.