All trusts providing paediatric cardiac surgery have been told to consider how to implement 119 recommendations made by the independent inquiries into services at the Royal Brompton Hospital and Harefield Hospital.

The inquiries' report, published this week, concluded that there was no evidence the hospitals discriminated against children with Down's syndrome in access to treatment, but that failures to provide families with 'a balanced view' of their options meant that such children were 'less favoured'.

The panel, chaired by Ruth Evans, former director of the National Consumer Council, called for key changes across the NHS, with regard to consent and provision of information to patients and parents.

It advised that key consultations should be tape-recorded, that parents should be given 'explicit advice' on their right to a second opinion, as well as clear and detailed information on the risks of surgery, and that consent to operate should be obtained by a senior doctor.

The panel also urged the Department of Health to introduce a national service framework for paediatric cardiac services, including guidance on staffing requirements, within 12 months.

The trust agreed to adopt all the recommendations, and Ms Evans said she had 'never known a report acted on so promptly' and that trust chief executive Mark Taylor was 'a magnificent advocate for families'.

The inquiries at the two hospitals, set up on the recommendation of an earlier review of paediatric cardiac surgery at the Royal Brompton, examined the concerns of 49 families whose children were treated for congenital heart disease between 1987 and 1999. Many died, some suffered neurological damage after surgery and a few were treated successfully.

The report concluded that some doctors at the Royal Brompton failed to provide 'a balanced view' of all the options available to the families of Down's syndrome children. 'This meant that such children were less favoured in accessing treatment. . . To their parents it was discrimination, 'Ms Evans said.

The report concluded that there had been inadequate funding for paediatric cardiac services at the Harefield Hospital up to 1992 and that Royal Brompton doctors believed cardiac services were 'seriously underfunded during the period under review'. It called for extra funding to increase the number of cardiac liaison nurses.

The Report of the Independent Inquiries into Paediatric Cardiac Services at the Royal Brompton Hospital and Harefield Hospital www. rbh. nthames. nhs. uk