More information is needed on the number of people harmed, or who die, while they are in hospital if a clearer picture of patient safety in the NHS and independent sector is to emerge, the Healthcare Commission has warned.
Almost a quarter (22%) of the 8000 complaints the commission receives each year are related to safety, it says. In the NHS, one in 10 trusts could not reassure the commission they fully met core standards on safety.
“It is frustrating that in 2006 we do not have a clearer idea of how many people die or are harmed in hospitals when this could have been avoided,” said Ian Kennedy, the chairman of the commission, launching its third annual report to parliament on the provision of health care in England and Wales, which was published on 30 October.
“We need to see a more consistent emphasis on safety,” he said. “Of course most people experience safe care, and where we find an urgent issue we have taken—and will take—action. But services could still be safer for patients. The NHS needs to take safety more seriously.
“We should all be troubled when the National Audit Office states that ‘estimates of death as a result of patient safety incidents range from 840 to 34 000,' but in reality the NHS simply does not know,” said Sir Ian.
He went on to acknowledge that the issue was affecting all countries, not just England and Wales. Without the data, it would be impossible to make improvements, he said.
“There is also clear room for improvement in compliance with standards on safety. And this goes for the independent sector, which needs to raise its game on this as well as the NHS.”
The report follows one published earlier in October, which looked at the systems for rating individual NHS trusts. This latest report provides more of an overview of the state of health care. A new legal requirement is inclusion of the independent sector in England.
The report also argues for more attention to services for people least able to look after themselves because of, for example, learning disabilities and mental health conditions.
Although there have been improvements, such as shorter waiting times and better treatment, there was still some way to go, said Sir Ian.
“The next step is to deal with the remaining ingrained problems, which are tougher nuts to crack,” he said.
Services needed “genuinely to be built around patients’ needs and wishes,” he said.
The commission has identified four ways to improve health care. These include delivering consistently safe care; providing services in a more patient friendly way; reducing inequalities in health; and improving services for those least able to care for themselves.
In the independent mental health sector 35% of establishments failed to meet three or more standards, and 12% failed to meet seven standards or more. These failures included not having a process to monitor treatment and care, not recruiting trained and qualified staff, and not having appropriate premises for the treatment provided. The NHS, the report points out, pays for about 80% of the people using these services.
Commenting on the commission’s call to put patients first, the NHS Confederation’s deputy director of policy, Jo Webber, said, “The NHS Confederation believes that we need to radically overhaul the way that we measure success in the NHS, by putting patient satisfaction and outcomes at the heart of a new approach.”
The report, State of Healthcare 2006 , is available at www.healthcarecommission.org.uk.