11.01.11
Public safety not improved by national confidential enquiries - research
New research has cast doubt on national confidential enquiries.
The investigations, which look at the reasons behind poor healthcare to improve patient safety drawing on systematic case reviews, are too expensive and come up with dubious conclusions, according to the research published in BMJ Quality and Safety.
They have their roots in the 19 th century, but the format has changed little since the 1952 National Confidential Enquiry into Maternal Deaths in England and Wales, say the authors.
They studied the longest-running enquiries as well as databases and government websites in the UK, US, Australia, New Zealand, Canada and Israel to discover that over 50 years, 27 enquiries have been carried out, 17 of them in the UK, with nine ongoing.
The authors found little evidence the enquires had improved safety and questioned the the validity of their recommendations because of the difficulties of attributing definitive cause to a series of cases without comparative data.
But clinicians set a great deal of store by the enquiry findings, say the authors: “This might be attributed to the non-threatening nature of confidential enquiries in which doctors’ clinical practice is discretely reviewed by themselves and their colleagues, with no involvement of managers, other healthcare professionals or lay people.”
The authors say the whole system needs to be reviewed.
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