health secretary matt hancock leaves 10 downing street

No room for complacency in patient safety in the NHS

Matt Hancock, the recently appointed Government, Health and Social Care Secretary, made a keynote speech on patient safety in London recently. The speech spelled out the future direction of NHS (National Health Service) patient safety policy development in England and also contained some very useful observations and policy which have relevance to patient safety policy developers globally, as well as in England.

Patient safety is a global problem

Hancock sits at the patient safety policy development pinnacle in the NHS as the Government Minister in charge of Health and Social Care. His decisions also have a global impact on patient safety policy development. The NHS in England is widely acknowledged as being one of the world’s leading thought leaders in patient safety policy development and practice.

The growing patient safety literature base

Hancock, in his speech, acknowledged that there is a great deal of patient safety information available and that it can be difficult for NHS staff to keep up to date with everything.

“I also know that there’s often a case of information overload. Multiple patient safety alerts about a huge range of issues, meaning it’s hard to prioritize which matters the most…”

There is now a large and growing national and global service industry surrounding patient safety and health care, which adds more stakeholders to the debate and complexity to the policy agenda. Lots of information, policies and practices are now regularly produced. This is positive, but the frequency and number of additions can also be seen as a negative. Matt Hancock recognizes the need to help NHS staff with this information overload.

A new NHS patient safety strategy

Hancock also spoke about cementing patient safety into the NHS with a new national patient safety strategy led by Aidan Fowler, the new NHS Director of Patient Safety.

He spoke about the huge progress made over the last few years on the NHS patient safety agenda, saying: “We’ve made huge progress over the last few years. The CQC is internationally recognized for its inspection regime – driving up standards across the NHS and improving care for patients.”

Not huge but steady progress

I would certainly agree with Hancock about the good work that the Care Quality Commission (CQC) has made over the last few years, and it is, in my view, recognized as a global model for health and social care regulation. The CQC itself recognizes, however, that patient safety is still its biggest concern in the NHS and repeats its concern again in its latest report, The state of health care and adult social care in England report, 2017/18 :

“The safety of people who use health and social care services remains our biggest concern. There were improvements in safety in adult social care services and among GP practices. But while there were also small safety improvements in NHS acute hospitals, too many need to do better, with 40 percent of core services rated as requires improvement and 3 percent rated as inadequate. NHS mental health service also need to improve substantially, with 37 percent of core services rated as requires improvement and 2 percent as inadequate.”

I would question whether we have made “huge progress” in recent years in patient safety in the NHS. I would say that we have made, “steady progress” instead. We regularly face record NHS clinical negligence claims, costs, and complaints. Never Events are still an acute problem and adverse health events are a fairly regular occurrence in the NHS even after the Mid Staffordshire and other subsequent crisis’s. Yes error is inevitable in health care given its essential nature and complexity, nobody is infallible.We can however all strive to reduce risk and to manage it properly.

The Secretary of State for Health and Social Care speech is to be welcomed. It is a clear clarion call for all health care staff to step up to the plate  and work on bringing about a safer NHS. There have been achievements in patient safety in the NHS but there is much more work to do.

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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