The National Health Service Litigation Authority and DNV are working together to improve the safety of NHS patients and staff.
The National Health Service Litigation Authority (NHSLA), which is responsible for handling negligence claims made against NHS bodies in England, aims to improve the safety of NHS patients and staff. To meet this goal, a dedicated team of DNV’s UK-based healthcare experts will be providing the NHSLA with integrated risk management services over the next five years.
“We look upon this as a partnership which we’re confident will improve both patient and staff safety and help the NHS to better manage its risks,” says Alison Bartholomew, Risk Management Director at the NHSLA.
Even though more than one million patients are treated safely by the NHS every day, health care is far more risky than most industries. To illustrate this point, statistics reveal that in the western world, 10 percent of all patient care is marked by error, of which five percent are fatal. Studies also indicate that in Britain there are 40,000 deaths annually caused by errors – it is estimated that up to half are preventable.
It follows that treating patients who are ill with potentially harmful drugs, increasingly complex technology, and the large number of people involved in their care creates an exponentially rising risk picture. A failure to adequately manage these risks can result in mistakes leading to harm which in some cases will be fatal or cause serious injury. Indeed, in 2005/06 the NHSLA paid some GBP 560 million on clinical negligence claims according to Ms Bartholomew. Whilst surgery gives rise to the largest number of clinical negligence claims managed by the NHSLA, obstetrics accounts for a third of the value of all such claims paid by the NHSLA.
In Britain alone, 1,800 million clinical decisions are made each year. “Traditionally, clinical education has focused on how to do things right, and not so much on the risks and mistakes that are also part of these professions,” says Ms Bartholomew. “Systems must be developed to manage the unavoidable fact that a certain percent of these decisions are wrong.”
Risky by nature
Acknowledging the risky nature of the healthcare industry, Ms Bartholomew is also quick to point out that important steps have already been taken to improve patient safety in the NHS but says more work needs to be done to build on improvements.
“Improving patient care is a significant challenge for health services around the world. However, recent reports show that improvements have been made across the NHS to embed patient safety into everyday practice and, although the vast majority of NHS patients receive safe and effective care, we have to recognise that in our modern, increasingly complex health service that treats significant numbers of patients every day, mistakes can and will inevitably happen. Often it is systems that have failed, rather than any individual being at fault,” says Ms Bartholomew.
The major causes of non clinical claims handled by the NHSLA, which mainly comprise injuries to NHS employees, are slip and trip incidents, and manual handling. Although there is an excess on all NHS staff claims which is paid by their employer, in 2005/06 the NHSLA paid more than GBP 30 million to settle non clinical claims made against NHS bodies. As Ms Bartholomew observes, ”Whilst the safety of NHS staff is important in itself, it is also a factor in ensuring patient safety.”
Since the NHSLA was established in 1995 it has had a statutory duty to encourage good risk management practices in the NHS with the aim of reducing the number and cost of claims. The NHSLA has mainly achieved this objective through an evolving programme of standards, based on the identified causes of claims, and assessments supported by education.
“In a report on patient safety published in November 2005, 26 percent of NHS chief executives ranked the NHSLA standards and assessments as the key driver for their boards to improve patient safety,” points out Ms Bartholomew and adds, “And, as one of the leaders in advocating patient safety, the NHSLA is increasingly working with other agencies on this important issue.”
Cooperation with DNV
In an effort to further develop its risk management programme, NHSLA has awarded DNV a contract to deliver risk assessment, standards development and maintenance, and training services to the 400 NHS trusts and 150 NHS maternity services in England.
Mark Boult, DNV’s healthcare market leader in the UK says that the scope of work focuses on improving the safety of NHS patients and staff and thereby reducing the potential for claims. He explains, “An important aim of the NHSLA is to contribute to a reduction in the number of negligent, or preventable, incidents occurring within the NHS bodies which are members of the NHSLA risk pooling schemes. It is essential, therefore, that there is an efficient process to reduce the potential for claims and improve patient and staff safety. To meet this challenge the NHSLA needs a partner to deliver the services effectively, in essence to provide a robust framework to support the risk management activities of scheme members, and reduce the number and severity of adverse events.”
Given DNV’s core competence in managing risk, Ms Bartholomew believes DNV is well placed to ensure the continued development and delivery of the NHSLA risk management programme. “The NHSLA considered that DNV’s existing activities, experience and knowledge would not only enable the organisation to enhance the delivery of the core services required but also add value through new ways of working and the provision of additional services, including the use of IT approach to education.”
Ms Bartholomew says the NHSLA views its relationship with DNV as ‘a partnership’ and there will be regular liaison and joint working between the organisations at all levels on an ongoing basis. “It is hoped that a strong relationship will be established between the two organisations which will facilitate the delivery of an effective, efficient and enhanced service which will make a positive contribution to the national agenda for the NHS.”