The NHS in England is being urged to reduce mistakes by half, as mistakes in hospitals cost the NHS around £2.5bn per year. Four aspects of poor patient safety include falls, bed ulcers, urinary infections caused by poorly fitted catheters, and deep vein thrombosis (DVT/VTE).
NHS errors costing billions a year – Jeremy Hunt. London: BBC Health News, October 16th 2014.
This relates to research commissioned by the Department of Health into costs of unsafe care in NHS. The report suggests the costs of preventable adverse events (such as medication errors and avoidable postoperative infections – plus litigation and correcting these problems, where possible) probably exceeds £1 billion annually, and could reach £2.5 billion per year.
Exploring the costs of unsafe care in the NHS: a report prepared for the Department of Health. London: Frontier Economics Ltd, October 15th 2014.
Safety Standards in Hospitals in England (CQC)
The Care Quality Commission (CQC) has warned about excessive variations in the quality and safety of care. Considering the 82 hospitals inspected in England to date under their new inspection regime, 8 were given an inadequate rating and 57 were rated as requiring improvement. Four out of five hospitals so far have been told their safety standards are (or were) not good enough.
Triggle, N. (2014). Hospital safety standards shocking, say inspectors. London: BBC Health News, October 16th 2014.
This relates to:
The state of health care and adult social care in England: 2013/14. Presented to Parliament pursuant to section 83(4)(a) of Part 1 of the Health and Social Care Act 2008. Ordered by the House of Commons to be printed on 16 October 2014. HC 691. London: Care Quality Commission, October 15th 2014.
Patient Safety Collaboratives
A national programme has been launched to improve patient safety, coordinated by NHS England and NHS Improving Quality (NHS IQ) A network of 15 Patient Safety Collaboratives are to be created, each led by an Academic Health Science Network (AHSN).
“The programme is borne out of Professor Don Berwick’s report last year into the safety of patients in England and builds on learning from the Francis and Winterbourne View recommendations”.
Read more: NHS IQ: Patient Safety Collaboratives.
Health Secretary launches new patient safety collaboratives. London [Online]: NHS Improving Quality (NHS IQ), October 14th 2014.
NHS England’s Never Events Policy Framework Review Consultation
NHS England has published a consultation on “never events” to help establish what needs to be done to prevent such events. The review will consider financial penalties for never events, and their possible inclusion in the NHS standard contract for 2015/16.
NHS England publishes Never Events Policy Framework Review consultation online. London [Online]: NHS England, October 8th 2014.
This relates to:
NHS England publishes Never Events Policy Framework Review consultation online. London: NHS England / Patient Safety Domain, October 6th 2014.
Positive Deviance: An Alternative Approach to Quality Improvement and Safety in Healthcare?
Positive deviance involves concentration on successful aspects of teams and organisations demonstrating exceptionally high performance. Regulators could encourage more knowledge sharing regarding examples of success, perhaps with less emphasis on fear of regulation and more on support for positive behaviour.
Lawton, R. Taylor, N. [and] Clay-Williams, R. [et al] (2014). Positive deviance: a different approach to achieving patient safety. BMJ Quality and Safety. November 2014, Vol.23(11), pp.880-3. (Click here to view the PubMed record).
Patient Information on Safety / Zero Harm Culture
The Secretary of State for Health’s latest message about improving patient safety in the NHS, covering the “Sign up to Safety” campaign plus a poster / leaflet and a free-to-use airline safety philosophy-like video:
Jeremy Hunt: message to NHS staff on ‘Sign up to Safety’ campaign. London: Department of Health, October 24th 2014.
One year after the launch of the Sign-Up to Safety campaign, 260 NHS organisations had plans to save lives by reducing preventable harm (such as medication errors, blood clots or bed sores).
Sign up to Safety scheme on track to save 6,000 lives. London: Department of Health, June 24th 2015.
Also of interest regarding harm-free care:
Airline-style patient safety film set to land in hospitals. London: Department of Health, October 23rd 2014.
Tools For Patient Safety in Primary Care: Thematic Review
A narrative review of the patient safety tools available for family practitioners identifies 114 tools, covering medication error (55%), safety climate (8%) and adverse event reporting (8%). Minor themes include informatics (4.5%), patient role (3%) and general measures to correct error (5%). Diagnostic error and results handling tend to feature little. Lesser topics (11%) include referrals, Out-of-Hours (OOH) care, telephone care, organisational issues, mortality and clerical error. There is little evidence yet about their utility for improving safety. The authors point to a lack of focus on diagnostics, systems safety and results handling.
Spencer, R. [and] Campbell, SR. (2014). Tools for primary care patient safety: a narrative review. BMC Family Practice. October 26th 2014, Vol.15(1), 166. (Click here to view the PubMed abstract).
Legal Costs in Clinical Negligence Claims
The NHS was charged £259 million on legal fees for negligence claims in 2013-14. Lawyers have been known to submit bills charging more than the patients themselves receive in compensation. The Department of Health plans to cap these charges by introducing a defined limit on legal costs in those cases where claims are valued below £100,000.
Medical legal costs ‘excessive and should be capped’. London: BBC Health News, June 28th 2015.
NHS negligence claims bill tops £1bn. London: BBC Health News, July 17th 2015.
The NHS Litigation Authority (NHSLA) is working, with limited success, to reduce the escalating medical negligence claims bill, which amounts to £1.4 billion per year:
Morris, J. (2016). NHS negligence claims hit £1.4bn. London: BBC Health News / BBC News, September 29th 2016.
The National Audit Office estimates the bill for medical negligence has quadrupled over ten years to £1.6 billion.
Litigation ‘threatening NHS finances’. London: BBC Health News, September 7th 2017.
“The negligence bill for mistakes made before 1995 – mainly maternity failings – has begun to rise for the first time in five years”.
Wilde, C. Lynch, P. [and] Belcher, A. (2018). Cost legacy of decades-old NHS blunders begins to rise. London: BBC Health News / BBC Shared Data Unit, January 16th 2018.