Stephen Ramsden on prioritising patient safety

If safety is our highest priority, we would expect to see many references to it. Yet the Department of Health's operating framework - which sets out NHS priorities for the coming year - does not feature improvement of patient safety, although it does mention infection and cleanliness.

But safety is far more than the prevalence of infection. Infections are only a fraction of the adverse events that take place in hospitals every day. Conservative estimates suggest that 10 per cent of inpatients suffer some kind of adverse event. This equates to some 7,000 adverse events every year for a medium-sized hospital. But at least 50 per cent of these are preventable.

Senior leaders of health organisations should ask themselves how much board time is spent each month discussing patient safety, measuring harm, analysing progress and assessing improvement. How many board directors can tell you the hospital-standardised mortality rate of the trust and, if they can, whether it is better or worse than last year's rate?

As leaders we have to demonstrate our commitment to patient safety. As the governing body we must meet national targets and show sound financial management, but not at the expense of safe care. We should state this explicitly to our staff and community.

Senior clinicians play a vital role in leading patient safety and must demonstrate that this is a priority. Over the past five years at my hospital, well-respected doctors have started to challenge their peers to stop "accepting the unacceptable". Until recently, ventilator-acquired pneumonia was considered an inevitable complication in intensive care units. Now our clinicians see this as a major unacceptable failure. Their stance is: "We know what to do to prevent it, and because we measure it we know how we are doing. We celebrate success and want forensic analysis of 'failure' to try to prevent it in the future." This is truly a mind shift. Imagine what could be achieved if every healthcare worker felt as strongly as this.

But the drive for safety does not stop at senior clinicians. Those working at ward level, those coming into contact every day with patients, healthcare assistants, porters, and reception staff all have a vital part to play. It is these frontline staff who set the tone of the organisation. These are the people who reassure patients that it is OK to ask questions about their care, and who tell them that the people looking after them want their participation in keeping them safe.

If we are really serious about patient safety, then organisations and staff can soon sign up to the "cause" of the National Patient Safety Campaign and demonstrate publicly that they truly believe this. Why not ask yourself: "What have I done today to help keep a patient safe?"