Table 3.
Preliminary list of never events for UK general medical practice with individual and combined Content Validity Index (CVI) scores
| Never event | Overall CVI score, %a | Expert reviewers (n = 17) | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | ||
| 1 Prescribing a drug to a patient that is recorded in the practice system as having previously caused her/him a severe adverse reaction | 100 | 4 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 3 | 4 | 4 | 4 | 4 | 3 |
| 2 A planned referral of a patient, prompted by clinical suspicion of cancer, is not sent | 100 | 4 | 4 | 3 | 4 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 4 | 3 | 4 |
| 3 Prescribing a teratogenic drug to a patient known to be pregnant (unless initiated by a clinical specialist) | 100 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 4 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 3 |
| 4 Emergency transport is not discussed or arranged when admitting a patient as an emergency | 94 | 3 | 2 | 4 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 4 | 3 | 4 | 4 | 4 | 3 | 4 |
| 5 An abnormal investigation result is received by a practice but is not reviewed by a clinician | 94 | 3 | 3 | 3 | 4 | 3 | 3 | 4 | 3 | 2 | 4 | 4 | 4 | 4 | 4 | 3 | 3 | 4 |
| 6 Prescribing aspirin for a patient <12 years old (unless recommended by a specialist for specific clinical conditions for example, Kawasaki’s disease) | 94 | 4 | 4 | 3 | 4 | 1 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 3 |
| 7 Prescribing systemic oestrogen-only hormone replacement therapy for a patient with an intact uterus | 94 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 1 | 4 | 4 | 4 | 4 | 4 | 3 | 4 | 4 | 4 |
| 8 Prescribing methotrexate daily rather than weekly (unless initiated by a specialist for a specific clinical condition, for example, leukaemia) | 88 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 2 | 4 | 4 | 4 | 3 | 4 | 4 | 4 | 2 | 4 |
| 9 A needle-stick injury caused by a failure to dispose of ‘sharps’ in compliance with national guidance and regulations | 88 | 4 | 1 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 2 | 4 | 4 | 3 | 4 | 4 |
| 10 Adrenaline (or equivalent) is NOT available when clinically indicated for a medical emergency in the practice or GP home visit | 88 | 4 | 4 | 4 | 4 | 2 | 4 | 4 | 3 | 4 | 1 | 4 | 4 | 4 | 3 | 4 | 4 | 4 |
Rating scale: 1 = not at all; 2 = it may be but only if reworded substantially; 3 = it fulfills the criteria for a never event but I suggest the following minor alteration(s); 4 = it is a never event and should be included in the final list.
a
Expert responders who rated the candidate never event ‘3’ or ‘4’.