Putting patient safety back at the heart of the NHS

Published on Wednesday, 23 February 2011 09:38
Posted by Scott Buckler

Just 6 per cent of people in England who have an alcohol problem are receiving treatment for it, as NICE calls for screening and better access to alcohol withdrawal services


An extended list of events that should never happen during care in the NHS has been unveiled today(Feb 23rd) along with a powerful financial disincentive....

...as the Government affirms that substandard care will not be tolerated in the NHS.
After engaging publicly with health partners like the NHS, health professionals, the Royal Colleges and the public, the current list of eight never events is to be extended to 25, and will now include events like:
•    severe harm/death due to transfusing the wrong type of blood;
•    severe scalding; and
•    severe harm/death due to misidentifying patients by failing to use standard wristband identification processes

“Never events” can cut a life unnecessarily short or result in serious impairment. It is important that the NHS tackles this issue head-on and continuously strives to provide the safe and high quality care patients expect. The NHS will still have a statutory requirement to report all serious patient safety incidents to the National Reporting and Learning System and to the CQC. Reporting of patient safety incidences plays a fundamental role in ensuring that the NHS learns the lessons from its mistakes, and makes sure they are never repeated.

Health Secretary, Andrew Lansley said:

"Our ambition is to modernise the NHS so that people have the highest quality healthcare, and live healthier, independent lives.
“Improving patient safety is central to this. We have identified 25 preventable incidents – “never events” – which should never happen in a high-quality healthcare service and for which payment can be withheld across the NHS.
“Never events” will be enshrined in the NHS Standard Contract, meaning that payment from GPs or other commissioners will be withheld where care falls short of the acceptable standard. The measures will help to protect patients and give commissioners the power to take action if unacceptable mistakes do happen.”

NHS Medical Director, Professor Sir Bruce Keogh said:

"The extended list includes avoidable incidents with serious adverse consequences for patients. No one wants these to happen, therefore we should not have to pay hospitals when these events occur. This will send a strong signal to leaders of the organisation to learn from their mistakes so they don't happen again."

There were 111 “never events” last year and more generally, medical errors of all kinds have been estimated to cost the NHS around £2bn a year. It is clear that safer care is cheaper care and that resources can and should be used to develop better health outcomes from the start of treatment rather than in putting things right when they have avoidably gone wrong.

Where "never events" do occur in the NHS, comissioners will now have the power to withhold payment for this extended list of events to NHS providers. “Never events” are so serious that the Government is defining the list of events on a national basis. However, it is right that local commissioners decide to what extent they will recover the costs of care associated with a “never event”. Commissioners will be able to cap the amount recovered if they choose to.

Source: ©DH

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