Comment

• Prevention is better than cure

Consultation response

• Developing the annual health check in 2007/08

Feature

• Safety in numbers

Case study

• Using leadership to improve safety

Prize draw

• Win a Spa Day in historic Bath

Prevention is better than cure

Stephen Thornton, Chief Executive, The Health Foundation

Welcome to the first issue in our new series of e-newsletters. As well as keeping you up-to-date with the latest developments from The Health Foundation, these newsletters will seek to get to the heart of the big issues affecting the quality of healthcare in the UK.

This month, our focus is on patient safety. This is a critical issue of global importance. Every day, lives are saved by talented and committed clinicians working in hospitals around the world. Despite this, there are still far too many cases where patients die or are harmed due to breakdowns in safety. In the UK, around one in ten patients in hospital experience an incident which puts their safety at risk. Furthermore, half of these incidents could have been prevented.

The airline industry – another high risk sector – has a far better record on safety than healthcare. This is because airline companies work proactively to prevent harm before it happens, rather than just reacting to safety issues once something has already gone wrong. Health professionals, regulators and the Government need to be similarly proactive when tackling patient safety.

There are some encouraging signs. The Department of Health is reviewing the standards by which the Healthcare Commission judges healthcare providers – both in the NHS and independent sector. I am very pleased that in 2007/8, the annual health check will focus on patient safety. However, I would like to see this go much further in terms of encouraging a proactive approach to safety.

Only one of the standards expects healthcare providers to work proactively to improve patient safety. The others assess how providers respond to harm once it has already occurred. This is essential, but the biggest improvements in patient safety occur when we proactively seek out harm. Hospitals need to put in place measures to reduce the likelihood of harm occurring, as well as having systems in place to learn from and act on adverse incidents.

It is vital that we work together to broaden the focus of patient safety beyond compliance with infection control measures. Through our Safer Patients Initiative, The Health Foundation is supporting 24 hospitals across the UK to test ways of reducing adverse patient safety incidents and mortality rates. This initiative is showing that, with the right skills and focus, patient safety can be significantly improved.

There are many ways to assess whether hospitals are working proactively to improve safety. For example, we could consider whether they have systems in place for monitoring and acting on key patient safety indicators such as hand hygiene compliance, outcomes from emergency calls and infection rates following surgery. We could also look at whether a hospital’s complaints database is linked with its risk register and if it has processes to elicit clinical views on areas of patient risk.

One of the chief executives involved in the Safer Patients Initiative recently told me that measuring adverse events to get a baseline is an entirely new approach for hospitals like his own. The data was critical for his hospital to understand the current situation, to work out where change was needed and to find out if the changes they made led to improvements in safety. He engaged with safety in a proactive way, and was able to demonstrate that patient outcomes had improved as a result.

Respond to author

Consultation response

Developing the annual health check in 2007/08

We agree with the Healthcare Commission that some of the Standards for Better Health are too detailed and could be simplified. We therefore support the review of standards as part of the alignment of standards for the independent sector and NHS providers.

Feature

Safety in numbers

Ensuring the safety of everyone who comes into contact with health services is one of the most important challenges facing healthcare today. Carol Haraden of the Institute for Healthcare Improvement outlines her vision of patient safety.

Case study

Using leadership to improve safety

Patient safety is literally at the top of the agenda for NHS Tayside, which provides primary, community-based and acute hospital services. Rather than finance or performance management, safety is the first issue discussed at the executive team’s weekly meeting.

Prize draw

Win a Spa Day in historic Bath

Register or update your details on our website this month for a chance to indulge yourself and a friend at one of the world’s oldest spas, compliments of The Health Foundation. Thermae Bath Spa offers bathing in natural warm, mineral-rich waters.