Last Friday I was lucky enough to attend Healthcare Conference UK’s London event entitled ‘Implementing the NHS patient safety strategy at a local level’. All in all it was a useful day, ably chaired by the interesting, insightful and incredibly charismatic Dr. Umesh Prabhu (pictured). He might not be everyone’s ‘cup of tea’ but if you are on Twitter, it is worth following him via @DrUmeshPrabhu. He talked a lot about our collective responsibility to improve care and his comment… ‘the standard we walk past is the standard we accept’ really resonated with me as someone who works in audit, patient safety and improvement.
What struck me about the day most were the key messages from the speakers. Rather depressingly, it was hard to see in some cases how we have made great strides forward since Don Berwick published his review of patient safety in 2013.
The key messages included:
NHS Resolution stating that the annual clinical negligence bill is continuing to grow at an alarming rate. Currently the NHS are spending £9 billion per year on clinical negligence and it would cost £85 billion if we settled all current claims tomorrow (wow!)
Douglas Findlay (Patient and Public Voice Partner) suggesting we could more effectively involve patients in safety. Plus, he raised concerns that Freedom to Speak Up Guardians in Trusts are not achieving all that they might
The suggestion that the NHS could do a lot better in the way that they manage incident and saying ‘sorry’ is still proving hard in some cases. According to one thematic review, only 35% of patients were offered an apology.
Of course, the new Patient Safety Strategy sets out details of how new systems will be implemented that in turn (it is hoped) will lead to improvements. To me, it feels like we have perhaps been here before! The final take home message was Dr. Prabhu’s statement that in the NHS we currently have 10,000 doctor and 35,000 nurse vacancies! With clinical staff facing increased workloads and more pressure, it is hard to see how we will reduce incidents in the short-term.
Footnote: on returning to the office on my next working day, I had a conversation with a local audit professional who described to me the current arrangements for the smoking cessation CQUIN and the BTS audit. Apparently, these ‘audits’ are virtually identical, with some Trusts collect data on the same patients for both! However, the data entry for each project is not the same. In an NHS under so much pressure in 2019 how are we as clinical audit and QI professionals allowing this to happen? How can we preach LEAN to others, when we produce duplicate audits? Sheer Madness!