Providers will need to invest “significant” time in ensuring frontline staff can deliver the plans to improve patient safety which were announced by the health secretary last week, HSJ has been told.
Jeremy Hunt said the NHS should halve rates of avoidable harm and confirmed the government plans to extend an organisational duty of candour to cover moderate harm as well as severe harm and death.
The duty of candour, requiring staff to tell patients where errors take place, is being introduced in the Care Bill, and will apply to all organisations regulated by the Care Quality Commission.
Secondary legislation on the rules, published for consultation last week, defines moderate harm as an incident leading to a “moderate increase in treatment; significant but not permanent harm and prolonged psychological harm”.
Partner in healthcare regulatory law at DAC Beachcroft Corinne Slingo told HSJ providers had a “significant job to do” to educate staff before the new regulations become law, which is planned for 1 October.
She said: “Providers will need to focus on how they demonstrate compliance. For NHS organisations and large independent sector providers, that will require a significant awareness campaign to make sure staff understand their roles and responsibilities in ensuring this duty is met by the organisation.”
Under the “Sign up to Safety movement”, which Mr Hunt announced, providers are being encouraged to develop their own plans to halve avoidable harm over three years.
The concept has been influenced by the work of the Safer Care South West collaborative which saw NHS providers in the previous NHS South West region reduce avoidable harm by 30 per cent over five years.
Medical lead for the South West project Tricia Woodhead told HSJ the key to its success was front line teams being supported to work on making improvements in their own services which could later be rolled out further.
The project trained staff in using the breakthrough collaborative methodology developed by the Institute for Healthcare Improvement in the US to test ideas for improvement. Salford Royal Foundation Trust has also used this methodology. Its chief executive Sir David Dalton said: “Boards have to build the capacity amongst staff. People won’t just get it.”
Organisations which produce convincing “sign up to safety” plans will be entitled to a discount on their NHS Litigation Authority premiums, Mr Hunt announced.
NHSLA Chief executive Catherine Dixon told HSJ that if organisations’ plans demonstrated that they “will reduce harm and subsequent numbers of claims the NHSLA will offer a discount in relation to that plan”.
She said if the reduction in claims was not realised, over a five year period, it would be taken into account when setting the organisation’s future premiums.
Health Foundation strategy director Jo Bibby told HSJ the health secretary’s plans marked the next step in improving safety in the NHS after successful campaigns to reduce “big ticket” harms such as healthcare acquired infections.
She said: “Once you’ve started to manage the big harms, the harm that’s going on is much more diffuse and what you need is a system of safety.
“For this to have the impact we want we have got to really make sure the resources are available to help people understand safety improvement.”
Hunt’s safety plans: Other elements
Safety Action for England (SAFE) team: NHS England will set up national support for trusts struggling with patient safety, building on learning from its accident and emergency and elective waiting intensive support teams
Incident reporting measure: the new measure will consider a range of indicators of good reporting culture including the ratio of serious to low harm.
Howsafeismyhospital.com website: will include data on prevalence of harms such as pressure ulcers, venous thromboembolism prevention and new data on nurse staffing levels which trusts must publish by June.