NHS reforms

19.12.18

Hundreds of patients a year harmed due to lack of safety directives as staff face ‘unmanageable’ pressures

‘Never events’ and avoidable harm to patients continue to happen across the NHS because doctors and nurses are too busy to enforce safety directives, a scathing report by the health inspectorate has found.

The CQC’s national report, ‘Opening the door to change,’ revealed that patients in hospitals and in surgery are being exposed to increased risk because NHS staff struggling with “unmanageable” workloads are unable to implement safety alerts.

Around 500 people each year are still suffering from ‘never events’ – serious and completely avoidable lapses in patient safety that can cause injuries or even death – with busy surgeons operating on wrong body parts and swabs being left inside someone during their procedure.

The findings come from a review of patient safety ordered by former health secretary Jeremy Hunt, and in response the CQC has called for a change in culture within the NHS.

The NHS inspector said that too many people are being unnecessarily injured because the NHS is not supported by sufficient training, and because the complexity of the current patient safety systems makes it difficult to ensure safety is at the forefront of everything they do.

Staff shortages, a high turnover of personnel, and confusion over the array of NHS bodies are all contributing to the high incidence of never events.

With the number of never events rising from 290 in 2012-13 to 468 last year, the figures raise questions over how much safer NHS care has become after a flurry of initiatives introduced across the NHS.

The CQC’s chief inspector of hospitals, Ted Baker, said: “NHS staff do a remarkable job to keep patients safe. But despite their best efforts, never events and other patient safety incidents continue to happen.

“In theory these events are entirely preventable: in practice too many patients suffer harm.

“Staff know that what they do carries risk, but the culture in which they work is one that views itself as essentially safe, where errors are considered exceptional, and where rigid hierarchical structures make it hard for staff to speak up about potential safety issues or raise concerns.

“We know there is a strong commitment to patient safety within our NHS and we must support staff to give safety the priority it deserves.”

The review, which was based on evidence gathered by inspectors during visits to 18 NHS trusts, identifies the need for a new programme of training and a change in culture to a more safety-centred approach.

NHS Provider’s head of policy Amber Jabbal welcomed the report, and stated: “Patient safety will always be a top priority for the NHS and CQC make clear that NHS staff are committed to ensuring that patients are kept as safe as possible.

“However, the CQC also found that funding, rising demand and workforce challenges make it difficult to learn from incidents and make changes effectively amid so many competing priorities, and that the current NHS approach to patient safety improvement adds confusion on top of these pressures.”

Image credit - Tempura

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