Can incidents of medical negligence be reduced if NHS trusts shared more data and information on medical errors?

Wright Hassall
November 8, 2014

Jeanette Whyman from Wright Hassall is a medical negligence solicitor with over 25 years’ experience and has acted both for and against Hospital Trusts. She now represents patients who are victims of medical negligence.

It would be a truth universally acknowledged among sensible people that the sharing of information on best practice, and the identification of meaningful trends gleaned from data, can only be a bonus for all organisations regardless of operation – and none more so than the NHS.

Therefore, it might seem obvious that sharing the background to a medical negligence claim could only be beneficial – enabling others to avoid it happening in their hospital. But, in my experience, it is rarely that simple. Medical mistakes occur for a number of reasons. Time and time again, I encounter situations where policies and procedures governing best practice are in place but certain individuals choose to circumvent them for a variety of reasons, and the hospital management is too weak to prevent them from doing so. The Stafford Hospital scandal is the most egregious example of accepted standards of clinical care being ignored by both medical and nursing practitioners and management, allowing institutional neglect to flourish.

Patient safety: data can pinpoint areas of concern

The Francis inquiry into what went wrong at Stafford resulted in over 290 recommendations being made to stop such widespread abuse of patients happening again. Since the report’s publication, a number of reforming initiatives have been announced, all designed to focus on the importance of hospitals establishing a patient-centric approach by inculcating a positive safety culture in which the needs of the patient are paramount. The government’s voluntary ‘Sign up for Safety’ initiative, endorsed by the NHS Litigation Authority (NHSLA), was launched specifically to help Trusts reduce the number of medical errors by a third. The NHSLA, in turn, has moved from assessing its members’ risk management standards (on the basis that the existence of a risk management system, of itself, doesn’t mean the Trust is safe) to an outcomes-based approach in order to help members identify and address areas of concern. This data will be published on an extranet, accessible to member Trusts, with the intention of helping them ‘prioritise local activity in areas where they have a high number of claims’. In addition, it has launched a new Safety and Learning Service which is specifically intended to help Trusts learn from their mistakes.

Enforceable Duty of Candour

One of the main recommendations of the Francis report, a statutory duty of candour (obliging honest and open dialogue with patients and their families) is coming into effect in October 2014, subject to parliamentary approval. There is a view in some quarters of the medical profession that a legal obligation of candour is unnecessary: doctors have always been subject to an ethical duty of candour which should not need legal enforcement. I disagree; I have been instructed on too many claims which have arisen because of an unwillingness to confront the error, no acceptance of responsibility and no apology. A statutory duty of candour will legally require organisations to be open, honest and transparent in all their dealings with patients. I seem to recall Michael Powers QC noting that if complaints were dealt with promptly and appropriately it would reduce the number of medical negligence claims by 70%.

Sharing information can reduce medical errors

Apart from rare instances of criminal behaviour, the majority of medical practitioners do not deliberately set out to hurt their patients. The publishing of data and information relating to outcome-based information can help Trusts to address problems before they become crises. Initiatives, such as Sign up to Safety, should help to prevent avoidable harm to patients by, as the NHSLA states, ‘shining a light on high risk, high volume and high value claims’. However, the danger posed by rogue practitioners will always be present and thus it is imperative that all staff, when encountering such instances are able to speak up without fear, supported both by their management team and by their legal duty of candour.