Nicholson tells Patient Safety Congress: create a safety culture

David Nicholson

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Chief executives have been told to create an environment where staff can report safety incidents instead of being "hung up to dry".

The fact that only 40 per cent of staff feel able to report incidents "simply isn't good enough", NHS chief executive David Nicholson told delegates at HSJ's Patient Safety Congress, organised jointly with sister title Nursing Times.

He said: "One of the things that really worried me about Maidstone and Tunbridge Wells is that the staff didn't feel they could put their hands up and say there was something wrong.

"This is a deeply dangerous place for an organisation to be. We need to create an environment where people feel there's a just system and they won't be hung up to dry when they raise safety issues."

Mr Nicholson said health minister Lord Darzi's upcoming next stage review will put a new onus on trusts to prioritise patient safety.

He said: "Sometimes we get ourselves engaged far more in the technical aspects of reform like practice-based commissioning... Sometimes we lost the point of why we were there."

Action against Medical Accidents chief executive Peter Walsh said staff should be legally mandated to report patient safety incidents.

He referred to HSJ's survey, in which 58 per cent of respondents said there was a "culture of denial" in the NHS. The poll revealed many staff were covering up safety incidents instead of feeding the information into national reporting systems.

Mr Walsh said: "What message does it give to say we refuse to introduce a legal duty of candour?... We have to stop sending out mixed messages."

The idea of a legal "duty of candour" was put forward by chief medical officer Sir Liam Donaldson as part of a review of the clinical negligence scheme in 2003, but it was never implemented.

Mr Walsh said current National Patient Safety Agency guidance, called Being Open, was too weak and needed to be put into statute.

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