The Royal Brompton Hospital was exonerated after an inquiry into its paediatric surgery, but dealing with the allegations was costly. Thelma Agnew reports

The worst summer of Mark Taylor's professional life began on 4 June with a fax from Private Eye columnist Dr Phil Hammond. 'He has a way of getting your attention very fast, ' says Mr Taylor.

Dr Hammond, patients' champion and scourge of the medical establishment, had received some shocking information about the outcome of children's heart surgery at the Royal Brompton Hospital in London, where Mark Taylor is chief executive.

The allegations - from an anonymous 'concerned professional' - were supported by 'confidential audit data for babies and children with Down's syndrome undergoing heart surgery at the Royal Brompton'.

It appeared that children with Down's syndrome had a higher mortality rate following surgery at the hospital than other children. And the whistleblower alleged that Brompton's surgeons were restricting Down's syndrome children's access to surgery.

Mr Taylor says he always felt that the allegations had to be wrong. In his long NHS management career he has not hesitated to bin complaints which clearly 'deserved to be ignored'.

'In this case I felt the issues were so substantial - and in the light of Bristol we have to be extremely cautious - I did have to do something about it.'

He brought in public relations heavy-hitter Jonathan Street, who advised him that there was no chance that Private Eye would 'leave it alone'.

Dr Hammond was informed that the trust would set up an externally-based independent inquiry.

Mr Taylor approached the Bristol inquiry for advice on selecting the review panel, and discovered that they had already been alerted to the allegations against the Brompton.

'We had come to the conclusion that clearly the allegations would become public, so we put out a quite explicit staff note, knowing it would find its way into the press.'

When the story did break, on the front page of the Sunday Times on 1 August, it was still a shock.

'Second heart hospital faces death inquiry' ran the headline. The Times presented the Royal Brompton as, potentially, another Bristol Royal Infirmary, and widened the story to include Harefield Hospital, which had not featured in the original allegations.

In the next few weeks the story snowballed. A newly formed Brompton Parents Group called for a public inquiry, winning the backing of Labour MP Ken Livingstone, who threatened to use parliamentary privilege to publish the names of the negligent surgeons. He also called for Mr Taylor's resignation.

Then, in September, the Brompton got the all-clear. The independent review found that the Brompton's surgical outcomes for children - with or without Down's syndrome - were similar to and mostly better than, results taken from the UK register.

The review panel, which focused on the statistical evidence, recommended that new allegations and individual parents' concerns should be looked at by a second panel, chaired by a lay person. It also called on the trust to improve data collection mechanisms, and communications with families.

But on the key issues - the competence and attitude of surgeons - the Brompton was vindicated. The panel reserved its sharpest criticism for the whistleblower who had caused 'so much disruption and damage' while 'shrouded by a cloak of anonymity'.

The Brompton's miseries may be nearly over but another 'story' - the enormous cost of unfounded allegations against trusts - is not about to go away.

Mr Taylor says the allegations cost the Brompton 'a six-figure sum', and 50 per cent of his time between June and September. Staff were 'angry and frightened' and parents of former patients were unduly distressed.

The saga has convinced him that the current complaints system should be overhauled to ensure a more 'proportionate' response to allegations.

'There is a disproportionate expectation on the part of the public about what level of investigation will take place. At Bristol millions are being spent, and people expect a similar level of resources to be made available for any investigation, ' he says.

Medical director Dr Tony Newman Taylor agrees. 'We have not covered up at all - we have been open, and people have not accepted it because there is a view that hospitals cover up. We need national guidance about the handling of these issues.'

In particular the status of, and response to, anonymous complaints needs to be looked at again.

'We took the view that it didn't matter what the source of the allegations was.

'But we do think that had it not been anonymous we might have been able to resolve it without such considerable costs in terms of time and money.'

Bad news day: how to handle it

Don't expect in-house press officers to cope. Bring in hard news experts.

Be consistent. You can't give interviews to one paper and ignore the rest.

Think carefully before putting up a manager or clinician spokesperson - you will be inundated with requests for interviews.

Act quickly to investigate the complaint.

Offer the complainant a chance to talk through their concerns with a clinician.

Be sensitive towards families and patient groups. Keep lines of communication open.

Put out something positive about the trust. If you don't you will be on the back foot from the start.

Keep staff informed, and support them through what is a traumatic process.

Accept that if you have a big name at your trust you will get more press attention than the story seems to deserve.