Patient Safety and Clinical Negligence

Reducing avoidable harm to patients is the obvious way to prevent unnecessary suffering. It is also the obvious way to reduce the amount paid by the NHS in compensation, and the costs associated with that.

Yet the link between injuring patients and the cost of putting things right when things have gone wrong is rarely discussed. 

The current approach to patient safety is impossibly fragmented. It is a patchwork quilt of programmes, recommendations and reports which is inefficient and lacks coherent leadership. Furthermore it is, demonstrably, an approach which has failed.

Since 2010, NHS organisations have been mandated to report all patient safety incidents resulting in severe harm or death. During that time no progress has been made in reducing the number of incidents. In fact, between 2010/11 and 2019/20, the number of these incidents actually increased by two per cent.

In First Do No Harm, the report of the independent medicines and medical devices safety review, Baroness Cumberlege delivers the following damning review of the current system:

We have found that the healthcare system …is disjointed, siloed, unresponsive and defensive. It does not adequately recognise that patients are its raison d’etre. It has failed to listen to their concerns and when, belatedly, it has decided to act it has too often moved glacially. Indeed, over these two years we have found ourselves in the position of recommending, encouraging and urging the system to take action that should have been taken long ago. The system is not good enough at spotting trends in practice and outcomes that give rise to safety concerns. Listening to patients is pivotal to that. 

A new Patient Safety Commissioner (PSC) is to be appointed by the Government, following a recommendation from First Do No Harm. Emerging as it has from this review, the PSC’s remit is currently restricted to issues relating to medicines and medical devices, but it is clear that there is now an urgent need to expand the role and create a meaningful link between patients, regulators, healthcare providers and policy-makers. Critically, the role is independent, and has the power to make organisations, including the Department for Health and Social Care, respond to it. Building on this existing policy is surely the simplest, quickest, and most coherent way of tackling the patient safety crisis and the cost, in both human misery and the need for redress, that accompanies it. 

Read our evidence to the Health and Social Care Select Committee Inquiry in APIL’s parliamentary room here: Parliamentary room (