The troubled National Patient Safety Agency is 'struggling' to cope with the massive number of reports it receives from trusts, the chief medical officer has revealed.
Professor Sir Liam Donaldson said that up to 2,000 adverse incidents in which patients were potentially put at risk of harm were being reported to the NPSA every day. Success had created unforeseen difficulties. 'We have defied the idea that no-one would report to us. Our problem now is how to identify the actionable learning. We are struggling with the volume of reports.'
Speaking to clinicians and managers at the International Society for Quality in Healthcare conference in London this week, Sir Liam said: 'There needs to be more emphasis on investigation, not just passive data collection. We need to not just to look at the retrospective analysis of what has gone wrong, but we also need to start looking proactively at the hazards and risk.'
The NPSA's joint chief executives, Sue Osborn and Susan Williams, were put on 'extended leave' in August and the organisation's future is part of a national review of safety, following criticisms from the National Audit Office and the Commons public accounts committee.
Sir Liam warned that the focus of patient safety had to change, with a return to examining the part played by individual clinicians or managers in adverse incidents. 'In the past we concentrated too much on the role of the individual and not on the role of the system, which has been a common cause of harm. Systems thinking is vital, but we have to ask ourselves if perhaps the pendulum has swung a little too far.'
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