Reducing medical mistakes

All the talk around patient safety is finally showing signs of translating into action as three different initiatives came together in the same week. On 24 June, Jeremy Hunt formally launched the ‘Sign up to Safety’ initiative, announced in March (blogs passim) which is a voluntary scheme designed to reduce medical mistakes by a third. At the same time, NHS Choices launched its new microsite wherein a range of data relating to patient safety has been published; and a review into the reporting culture of the NHS, led by Sir Robert Francis QC, was announced.  Since the Mid-Staffordshire scandal, patient safety has been top of the political agenda with promises to reform the system coming thick and fast; at last these pledges now seem to be bearing fruit.
 
1. Sign up to Safety
 
This campaign is being led by Sir David Dalton, Chief Executive of Salford Royal Hospital and, so far, 12 NHS Trusts have signed up, developing plans to show how they will reduce ‘avoidable’ harm such as infections caused by lack of cleanliness, medication errors and blood clots.  In other words, by looking after the small stuff, the big stuff has a better chance of looking after itself. This may seem like common sense but, as shown by the scandals following in the wake of Mid-Staffs, some hospitals have had to be reminded what they’re actually there to do and the proper environment in which to do it. So many medical negligence and NHS compensation cases that I see stem from a relatively minor cause or event which, had it been picked up and addressed early on, should not have caused the sort of harm that would lead to a claim. The fact that each ‘Sign up to Safety’ plan has to be reviewed and signed off by the NHS Litigation Authority - which then helps to finance the implementation of the plan - says it all.
 
2. Patient safety data
 
In the quest for openness, the NHS Choices microsite publishes a range of data enabling members of the public to assess their local hospital against seven criteria:  CQC standards; ‘open and honest’ patient safety reporting; safe staffing levels; infection control and cleanliness; assessment for risk of blood clots; responding to patient safety alerts; and, finally, whether staff would recommend their hospital to friends and family. Of course there is the small issue of data interpretation and missing data which skews the results for some hospitals but, overall, this must be a worthwhile project. The latest set of data to be added is that of actual staffing levels - down to ward level - along with planned staffing levels. Naturally this data does need to be viewed with a degree of caution while it beds in – for instance a fifth of NHS acute trusts are rated ‘poor’ for reporting on patient safety. Taken at face value, this sets alarms ringing but is it that patient welfare is seriously compromised in this number of hospitals or is it that they are behind the curve in data collection, management and interpretation? Publishing the data will be an excellent incentive for hospitals to get their acts together.
 
3. The latest Francis Review
 
Sir Robert Francis QC, who led the inquiry into the Stafford Hospital scandal, will be heading up in independent review: ‘An Independent Review into creating an open and honest reporting culture in the NHS’. His objective is to ensure that staff faced with a serious breach of patient safety do not feel prevented in any way from reporting their concerns or to feel that taking such action will compromise their employment.
 
4. Conclusion
 
Some hospitals have already discovered the benefits of gathering and interpreting data to help them improve on services delivered. University Hospitals Trust Birmingham has been using data to drive patient care for some time, helping to uncover trends and promoting best practice across disciplines. Hospitals are large, complex organisms and the level of specialisation means that departments can operate different sets of standards under the same roof. As I’ve said in the past, by being upfront, open and honest about shortcomings and medical mistakes, hospitals can avoid negligence claims being lodged and lay the foundations for future best practice.

This article is courtesy of Jeanette Whyman, a Medical Negligence Claims Solicitor with Wright Hassall; she has successfully secured NHS Compensation for many victims of medical negligence.