• Project was led by Birmingham Children’s Hospital NHS Foundation Trust, as extension of phase two of the Health Foundation’s Safer Clinical Systems programme.
  • Focused on the surgical clinical care pathway at Birmingham Children’s Hospital.
  • Aimed to test the feasibility and effectiveness of the safety case approach in a complex care pathway.
  • Developed a safety case and examined questions, including the level of resources required, its usefulness compared to traditional safety assurance systems and how it could support board-level decision making.

The Birmingham Children’s Hospital NHS Foundation Trust project tested the feasibility and effectiveness of using a safety case approach to understand hazards and risks in a complex care pathway. The project focused on the plastic surgery clinical care pathway, which spans multiple teams and departments.

The work followed on from the trust’s earlier Safer Clinical Systems project, which had applied the safety case approach to the hospital at night handover system. The new project further explored the usefulness of the safety case approach in a non-industrial health care context, by testing it within a more variable and complicated clinical pathway system. The team examined questions such as:

  • how the methodology could be adapted and scaled up to suit the complexities of the care pathway
  • how the approach could be used to engage clinical teams in defining the safety requirements of a system and understanding existing hazards
  • what resources and skills were needed to develop and maintain the approach
  • how useful it was compared to the risk management and safety assurance systems that were in use
  • whether it supported the development of interventions to reduce hazards
  • how it could support board-level decision making on safety issues.