In response to public concerns and inquiries into the quality of care at a number of specialist centres in the UK, most notably the Bristol Royal Infirmary, the Department of Health initiated a review of NHS paediatric and congenital cardiac services. The initial report of this review was published in November 2002.  The report set out twelve standards for services for the care of patients with congenital heart disease. As well as standards relating to the quality of medical and surgical care, the need for screening and early diagnosis, and the importance of information and support for patients and parents, the review included a standard to recognise the need for age-appropriate care and services for adults with congenital heart disease.