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Enhancing Patient Safety Education and Training through Legal Study

By John Tingle

In the new NHS Patient Safety Strategy for England there is a discussion of patient safety education and training. While safety is now better understood there are significant numbers of people who still have a limited understanding of safety science.

A National Patient Safety Syllabus

A commitment is made to have a universal patient safety syllabus and training program for the whole of the NHS. Health Education England (HEE) will have a pivotal role:

HEE will work with NHS Improvement and NHS England to produce the best informed and safety-focussed workforce in the world. Developing a consistent national patient safety syllabus to apply across a variety of competence levels and address the different learning needs of 1.3 million staff in 350 different careers is an enormous undertaking.

Developing a national patient safety syllabus will be challenging given the various health care professions in the NHS. Syllabus developers will also need to take into account of the myriad national and international patient safety stakeholders that exist, with many having competing education training policy agendas.

The development of patient safety education and training is an essential pre-requisite to developing an ingrained NHS patient safety culture. It is stated in the new strategy:

All staff will follow the same syllabus. However, working with system partners, HEE will ensure that this high quality patient safety training is available to staff at an appropriate level, from an introduction to patient safety for staff new to the NHS to specialist training modules for our proposed patient safety specialists and others who are interested.

Is patient safety purely a science?

The strategy states, ”significant numbers of people still have a limited understanding of safety science.”

I think it is possible to take issue with the term “safety science” as used above. Surely any national patient safety syllabus should also reflect the humanities and social science subjects. Patient safety is by no means a purely science-based subject. Health care ethics and law should have a place in any proposed syllabus as well. There are key areas where health care law and ethics can make an important contribution.

Conceptual Subject Silos

The dangers of working in subject conceptual silos has been well articulated by the National Audit Office (NAO) in its report on managing the costs of clinical negligence in hospitals and other health organizations where it was stated that the government needs to take a stronger and more integrated approach to fundamentally change the biggest drivers of increasing cost across the health and justice systems. More aligned, holistic thinking between government departments and other agencies is needed to share solutions and challenges.

Similarly in terms of a national patient safety syllabus, a holistic approach to its creation is similarly needed, otherwise a narrow view of the patient safety policy debate and issues emerges.

The Law

The law sets the framework and context from within which health care is delivered. It sets levels of competence and can imprison in some circumstances for failures as well as ordering compensation to be paid. It is both a punitive and a facilitative framework. The law safeguards, protects the weak and incapacitated, and advances human rights in health care. The courts are frequently asked to make life and death decisions in health care treatment disputes.

The role of law is patently fundamental to any discussion of patient safety and it should occupy a prime position in any global, national, and local patient safety education and training syllabus.

John Tingle

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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