Stephen Thornton's opening speech to the Patient Safety Congress 2010

'First, to be reminded that huge progress has been made in Patient Safety in last decade.

'As Liam Donaldson retires as CMO let us remember his seminal work An Organisation with a Memory published exactly 10 years ago in June 2000: “Adverse health care events cannot be eliminated from complex modern health care”, he said, “but the recommendations of this expert group are designed to ensure that lessons from the past are used to reduce the risk to patients in the future.”

'This stimulated action right across the service, not least the Health Foundation’s Safer Patients Initiative.

'In that context I want to pay tribute to many of you in this room:

'By participating in the NPSA-led Safety First, the Welsh 1,000 Lives Campaign, the Scottish Patient Safety Alliance, its Northern Ireland equivalent, or in one of the Health Foundation funded safety initiatives, or by simply going it alone you have learnt speak up for safety with passion; you have built technical capability to make lasting change on the ground; you exhibit real leadership for safety in your organisations.

'As tough decisions are needed let’s not lose momentum.

'If I have one word for Government it is to remind them that this focus is now unstoppable.

'However, two things Andrew Lansley could do could make a big difference:

'First, as you cull the quangos, do so with care.

'As more and more of the chairs are taken away in what will be a vicious round of musical chairs for quangos and NHS management bodies, beware of the unintended consequence of losing the scarce resource that has been painstakingly built up over the past decade.

'I am not here as an advocate of any particular organisation. I recognise the urgent need for government to act. But suffice for me to say from outside the system that it would be a retrograde step if the core capacity and extensive distributed capability of the NIII and the NPSA for improvement in general and safety in particular were scattered to the four winds. The Foundation’s own considerable complimentary investment in building and sustaining networks of those leading improvement and safety can be no match for the system itself sustaining such capability.

'Second, as you come to terms with the need for tough local decisions in service configuration, keep a strong focus on what the evidence tell you about the safety implications.

'Beware those who will play the patient safety card, simply to defend their own interests.

'Inevitably, there will be a strong clinical professional voice masking vested interest with cries of potential damage to patient safety, especially where change requires radical changes to professional roles and status. Conversely there will be managers using safety fears as a cloak for changes driven solely by the need to save cash. Amidst all of this, local politicians and the media will jump on any passing patient safety bandwagon.

'How do I read the early signs? Is Government keeping its eye firmly on the evidence?

'On the one hand I could say they are not good. Sweeping statements made during the election by the Tories about no forced closures of A&E departments and maternity services have been confirmed in office. Andrew Lansley’s unwillingness even to read the NHS London proposals let alone act on them, combined with the Nicholson moratorium on all major reconfigurations does not bode well.

'Remember, the status quo is not always a safe option. Research published today by the Health Foundation and available from our stand, shows:

• 15% of out patient appointments affected by missing data
• 15% of newly written medication orders with a prescribing error, and
• equipment problems in 19% of surgical operations.

'However, let’s look beneath the headlines. Might not Secretary of State have a point when he asks why we have plans to shut maternity units on safety grounds that are bigger than the biggest such units in France where outcome results are so good?

'So, Andrew, put patient safety centre stage; build on the best of what is already underway; nurture the scarce resource you have for implementing and leading safety improvement; and resist those telling you improvement is not possible by forcing them back to the evidence.'