Intelligent Transparency and Patient Safety: New UK Government Patient Safety Plans Launched

By John Tingle

One thing is clear when commentating on patient safety developments in the UK is that there is hardly ever a dull moment or a lapse of activity in patient safety policy development .Something always appears to be happening somewhere and it’s generally a very significant something. Things are happening at a pace with patient safety here.

On the 3rd March 2016 the Secretary of State for Health,The Rt Honourable Jeremy Hunt announced a major change to the patient safety infrastructure in the NHS with the setting  up from the 1st April 2016 of the independent Healthcare Safety Investigation Branch. In a speech in London to the Global Patient Safety Summit on improving standards in healthcare he also reflected on current patient safety initiatives.This new organisation has been modelled on the Air Accident Investigation Branch which has operated successfully in the airline industry. It will undertake, ‘timely, no-blame investigations’.

The Aviation and Health Industries
The airline industry has provided some very useful thinking in patient safety policy development when the literature on patient safety in the UK is considered. The way the airline industry changed its culture regarding accidents is mentioned by the Secretary of State in glowing terms. Pilots attending training programmes with engineers and flight attendants discussing communications and teamwork. There was a dramatic and immediate reduction in aviation fatalities which he wants to see happening now in the NHS.
Key to this new agency will be that legal protection afforded to those who speak honestly to Healthcare Safety Investigation Branch investigators. The results of investigations will not normally be allowed to be used in litigation or disciplinary procedures. The idea is to create, ‘a safe space’, reducing the defensive culture so that a learning culture can thrive.

Intelligent transparency
In the patient safety and health quality literature over the years certain ‘buzz words’ appear  and then seem to disappear.In my own research ‘patient advocacy’, ‘clinical governance’ are terms which spring to mind. The Secretary of State has a term which he uses a lot and this is,’ Intelligent Transparency’. These are good words and describe how a health system should open up its doors to review by the public, be transparent and accountable for the health care that it provides. This concept can now be said to permeate through modern NHS patient safety policy development. Making healthcare more human-centred and not system centred . Moving away from the bureaucratic.

League Table on Transparency
There are a number of  patient safety and quality reports now publicly available that reflect the concept of ‘Intelligent Transparency’ .The most recent one just published is a league table identifying levels of openness and transparency within NHS trusts and Foundation trusts. A number of famous London Hospitals can be seen in the table as requiring improvement.Eight providers were rated as outstanding,102 were good,78 gave cause for significant concern and 32 had a poor reporting culture.

May, the concept of ‘Intelligent Transparency long continue in the NHS and hopefully it will also find a welcome home in other countries health system, it’s an excellent concept.

John Tingle, Reader in Health Law, Nottingham Law School, Nottingham Trent University, UK

John Tingle

John Tingle is a regular contributor to the Bill of Health blog. I am a Lecturer in Law, Birmingham Law School, University of Birmingham, UK; and a Visiting Professor of Law, Loyola University Chicago, School of Law. I was a Visiting Scholar at Harvard Law School in November 2018 and formerly Associate Professor at Nottingham Law School, Nottingham Trent University in the UK. I have a fortnightly magazine column in the British Journal of Nursing where I focus on patient safety and the legal aspects of nursing and medicine. I have published over 500 articles and a number of leading texts in patient safety and nursing law. My current research interests are in global patient safety, policy and practice, particularly in African health care systems. My most recent publication is: "Global Patient-Safety Law Policy and Practice," edited by John Tingle, Clayton O'Neill, and Morgan Shimwell, Routledge 2018.

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