Published: 06/02/2003, Volume II3, No. 5841 Page 10

Constant structural change in the NHS could put patient safety at risk, according to one half of the management team developing the health service's patient safety watchdog.

Sue Williams, joint chief executive of the National Patient Safety Agency, told an HSJ conference on patient safety last week that evidence in other industries revealed that organisational change could increase errors in the workplace.

She said that although there was no evidence available from other healthcare systems, studies in the chemical industry had shown that errors increased where there was significant organisational change.

'It might happen because people are thinking about other things.

Organisational change in the NHS tends to affect management more than clinicians, but though we do not know what the impact of organisation change will be on adverse incidents in the NHS, we will watch out for it, ' she promised.

But Ms Williams told the conference that research on international healthcare systems had shown that the final structure of the service made little difference to the rates of errors.

Responding to a question about whether the introduction of foundation trusts could increase risk to patients, she said: 'Healthcare across the world is funded and structured differently, but they all have similar errors. Therefore the important thing is about having systems that will reduce harm and that can work in any structure.'

Chief medical officer for England Professor Sir Liam Donaldson said that while foundation trusts could introduce positive competition to the NHS, it was important that robust data on the quality of services was available so that trusts could judge themselves.

He said that foundation trusts should throw their doors open to other trust managers to offer a first-hand view of best practice.

Sue Williams also revealed that the NPSA is currently running 40 pilot reporting systems which will be monitored with the intention of rolling them out in July. An email reporting form is being used, tailored to meet the needs of mental health and ambulance trusts, dentists, pharmacists and GPs.

Ms Williams said talks are ongoing with the Medical Devices Agency to see if one form could be used for errors that would be reported to both the MDA and NPSA. She said four members of every trust will be offered training in root-cause analysis of errors and one risk manager will be appointed for every English strategic health authority, with one in Wales.

Ms Williams said the agency was due to visit the Treasury to have its plans for the 'second biggest IT scheme in the NHS' vetted this week.

She said that although the agency's IT system would not be hugely costly (around£7m over eight years), it would be highly complex. The NPSA will access the risk management schemes that already exist in the NHS and Ms Williams said it was important that the agency did not 'clog up' the NHS's IT network.