Having worked with the NHS, not-for-profit and private healthcare providers in the UK for several years, it is fascinating to be a newcomer to the world of patient safety, particularly in 2017.
For fellow newcomers and experienced practitioners and managers alike, it is fruitful to continually reflect on the patient safety movement’s “why”, its direction of travel and the ways it really does make a difference to care provision.
The past few years have been a time of real change and maturity in the world of patient safety. The 2000s were a time of flux, with various high profile NHS scandals, not least at Furness General Hospital and Stafford Hospital.
Inquests, investigations and public inquiries are nothing new in healthcare. The larger scale of those since the turn of the millennium probably does not signal an increase in the number or severity of incidents causing harm in our health system, rather an increased assertiveness from families to struggle for the truth and, at times, an increased appetite from the media and the public at large to understand systemic problems in care and what can be done about them.
As a newcomer, comparisons to broader health and safety culture help to put it all in perspective. Despite holding many distinctive characteristics, an improved culture of patient safety is consistent with, and in part relies upon, an improving safety culture in society in general.
The shifting culture in society at large can be seen through the public outcry at major failures in safety culture. This has recently been highlighted by the Grenfell catastrophe. This raised serious public concerns around how the reporting of safety concerns were managed, as well as debates around how the construction and housing industries learn from the mistakes that occurred. Mostly gone are the days when a tragedy is seen as simply “one of those things” and not avoidable, with no attention to the lessons to be learned.
The broad shift towards a safety culture in society, and a culture of reporting and not blaming, can be seen through crime statistics. In July 2017, media reported a 10% increase in official reports of crime. Looking beyond the headlines, surveys of people’s actual experiences showed a 7% decrease for the same monitoring period; a highly justifiable conclusion is that crime is likely to be fairly level, but there has been a significant culture shift towards victims of crime reporting their experiences, rather than feeling that their crime report would disappear into a “black hole”, or worse, they would be apportioned blame.
The recent shift towards a patient safety culture does not exist in a vacuum; it sits within the context of a greater public awareness of safety issues and an increasing eagerness to learn from adverse events. If society adopts a safety-first mindset and a just culture as default, then adopting these concepts within the healthcare environment should be far less challenging. For this reason, it certainly is an exciting time to be joining the patient safety movement.
Luke is the Datix Account Manager and first point of contact for over 100 healthcare organisations that use Datix for patient safety. This includes NHS Trusts, CCGs, CSUs, charities and private sector providers. Contact Luke.