A fresh approach to patient safety?

Peter Walsh

Peter Walsh

by Peter Walsh
Chief Executive of AvMA

June 2019

At the time of writing we are eagerly awaiting the new patient safety strategy for England from NHS Improvement. This is expected to be launched on 2nd or 3rd July. Our hope is that the new strategy can breathe new life into England’s approach to patient safety rather than just be more of the same or even take things in the wrong direction. I think there is reason for cautious optimism.

From what we know so far, the strategy should definitely include the following:

  • A revised ‘serious incident framework’ covering when and how serious incident investigations should be run
  • A commitment to do more on developing a ‘just culture’ conducive to improving patient safety
  • Strengthening the ability of staff involved in patient safety to conduct good quality investigations and implement patient safety improvements that have impact
  • Improving the role that patients can play in patient safety including developing a network of “patient safety advocates”

Clearly, we will need to see what the new strategy actually says and to what extent it has taken on board suggestions made during the consultation before we can make any judgements. However, I would like to set out some of the hopes I have.

Serious Incident Framework/patient safety investigations

I am hoping the strategy will have something meaningful to say about how patients/family members can be properly empowered and involved in investigations. In particular, rather than trusts simply being implored to signpost people to sources of independent advice and support, I hope the strategy will acknowledge the need to ensure that capacity exists in organisations that can provide this help, through the provision of funding.

‘Just culture’

There is a lot of talk about this whilst there being a clear definition of what is meant by ‘just culture’ or concerted action to support it. Just culture is still too often talked about purely in terms of being fair to staff. It needs to encompass being fair to patients also. Misguided initiatives such as imposing ‘safe space’ non-disclosure must be avoided.

Developing both staff and patients’ role

Nationally recognised training and accreditation for patient safety staff would be a big step forward. So would a well designed and resourced project to enable patients to play a role in overseeing and developing approaches to patient safety. The proposed initiative to have ‘patient safety advocates’ should apply to every trust. Lessons should be drawn from AvMA’s work with the now defunct National Patient Safety Agency on this. Patient Safety Advocates should have support and their own network, independent of NHS bodies.

Watch this space for news of what the new strategy actually says, and AvMA’s reaction!