The key intervention that Medway foundation trust has put into practice is the reducing harm from high-risk meds intervention. This aims to reduce harm from five high-risk medicines with a specific focus on insulin. 

Helen Goodwin, head of governance and risk at Medway foundation trust, said: “Insulin levels can sometimes be difficult to control after surgery so normal insulin regimens do change with varying dosages and different types of insulin prescribed. The change from intravenous sliding-scale insulin during and immediately post surgery back to a subcutaneous route has resulted in patients suffering from hypoglycaemic and hyperglycaemic episodes.

“There were also a number of near-misses with nurses misreading prescriptions.”

In Medway’s case, one problem was the design of the prescription form. Instead of having handwritten prescriptions which can be easily misread, they began to use pre-printed stickers with IU on so that the letters ‘IU’ were not mistaken for an 0 which could lead to a higher dosage of insulin.

The whole trust, from the members and governors to doctors to nurses have re-jigged their agenda to make patient safety a priority in the trust. 

Loïs Howell, company secretary at the trust, says that patient safety is important to everyone from ward to board. Key among the patient safety measures they have introduced are patient safety walkrounds – execs and non-execs work in pairs and pay visits to different parts of the hospital. 

Ms Howell says: “We use posters to advise teams that we are coming to visit and that we really want to talk to everyone about the patient safety issues staff see on the wards, and what they want to do about them. From summer onwards, we will have governors accompanying us on these visits too.

“We have also organised patient safety focused away days for clinical directors and board members so that everyone knows the importance of patient safety and can lead by example.  We think it helps to emphasise the importance of patient safety to the whole trust if all directors, not just the clinically qualified directors, are involved, so I help to promote the message wherever possible, along with the director of finance and the HR director. 

So far Patient Safety First is going very well for us and we are very engaged with the campaign on all levels.”

For more information visit

Have another idea or suggestion to share with HSJ readers? Send it to