Champions of Patient Safety: The people part of Human Factors

Jeremy Hunt wants a seven day NHS. Well for the record the last time that I needed the NHS at the weekend it was definitely there and the service I got was as good as it always is. But I’m willing to accept the theory that it would be better if all of the things that it does, are available every day of the week. Jeremy Hunt’s argument is that doing this would make the NHS better and safer for patients. As we all know – in pursuit of this objective the Secretary of State has negotiated (sort of) and then imposed a new contract on junior doctors and as we all also know – the junior doctors aren’t very pleased about this.

At the same time as this, Jeremy Hunt has also become a Champion of Safety. Last week he launched his Global Patient Safety Summit at which he announced the creation of The Healthcare Safety Investigation Branch (HSIB). Which apparently will be a safe investigatory space that can investigate a limited number serious patient safety incidents and will begin by focusing on maternity services.  In addition to this, yesterday there was a question in Prime Ministers Questions praising the work that the Secretary of State was doing in the field and Scott Morrish the parent of a child who died from medical error, wrote an article for the Times in which he outlined his own personal experience and then praised the establishment of HSIB. Which is not altogether surprising because he was part of the group tasked with its formation. His article, like that published by James Titcombe on his blog yesterday was profoundly moving.

Patients’ experiences are extremely important. Our stories can and often are used as a lever with which to change and transform established practices and power relationships. The stories of James Titcombe and Scott Morrish are examples of the kind of patient/parent narrative that can and should change the way in which things are done. But the way in which families stories are used is rarely politically neutral. Often we will be brought into conflicts where senior managers and politicians want change and staff and trade unions don’t, and the current government initiative is such an instance. The patient safety stories of people who have been the subject of medical error have become a weapon in Jeremy Hunt’s dispute with junior doctors and his broader drive to create a seven day NHS.

Now you might well argue that having a 7 day NHS would be safer and that the pay rise offered to junior doctors might be reasonable and I’m not going to argue with you either way. What I will say is that any kind of systemic or cultural approach to patient safety is going to be dependent upon the wholehearted commitment and support of junior doctors for it to work. The struggle for a safer NHS cannot achieve progress in the context of the kind of relationship that the government currently has with its junior doctors. And the learning that might arise from considering Scott and James’ stories in a more constructive environment is likely to be lost in the white heat of the current conflict.

A safer NHS is one that will be built on collaboration, consensual leadership and a collective drive to make the NHS safer for its patients. And as families and patients we need to be wary of becoming embroiled in politicians’ battles, because in the end the Champions of Patient Safety that count aren’t going to be the Secretary of State and probably not anybody else that was at the recent Global Summit – it will be junior doctors, consultants, nurses, support staff and families working together – the people part of Human Factors.


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