Fragmented patient safety tactics won’t solve NHS crisis

Efforts to reduce avoidable deaths and severe injuries in the NHS will fail unless a coordinated and comprehensive strategy is adopted, according to a leading campaign group. The Association of Personal Injury Lawyers (APIL) has expressed concern that current patient safety initiatives are too fragmented and lack the strong leadership needed to make meaningful progress.

Guy Forster, joint vice president of APIL, highlighted the growing crisis in patient safety, pointing to a rise in severe harm and deaths due to medical incidents. "There is an urgent need for a coordinated, overarching strategy to tackle the issues which cause needless injuries and deaths in the NHS in the first place," Forster stated. He criticised the current approach as "extremely fragmented, with a multitude of programmes, frameworks, reporting schemes, and organisations."

This warning comes as the Patient Safety Commissioner for England outlined new principles aimed at improving safety across the healthcare system. While Forster acknowledged that these principles are a positive step, he emphasised that they are unlikely to succeed without a fundamental change in how patient safety is managed. "These principles, while laudable, will not work without strong and coherent leadership in patient safety, with meaningful links between patients, regulators, healthcare providers, and policymakers," he added.

APIL’s analysis of NHS data reveals a worrying trend: in the decade leading up to 2022/23, there was a 30% increase in incidents resulting in severe harm or death, with 14,383 such incidents recorded in 2022/23 alone. Severe harm includes permanent injuries such as loss of sight or mobility. "Every day on average, 39 patients die or are severely injured because of a patient safety incident," Forster pointed out.

Forster also raised concerns about ongoing issues with transparency and openness within the healthcare system. Despite the introduction of a statutory duty of candour in 2014, which legally requires healthcare providers to be open and honest when things go wrong, families continue to face difficulties in obtaining information about what happened to their loved ones.

"Our members often represent patients and relatives who have been left in the dark about what happened," Forster said. "They struggle to move on and rebuild their lives as a result. At times, individual healthcare staff apologise for failings initially, but as hospital trust investigations get underway, a wall of silence emerges, and accountability is denied again and again."

The lack of consistent application of the duty of candour is seen as a major barrier to improving patient safety, with Forster noting that the quality of engagement with affected patients and families remains poor. "There will be no improvement in learning from failings until healthcare staff all adhere to the duty of candour and live and breathe a culture of transparency," he warned.

Forster's comments underscore the need for more than just isolated reforms or principles. Without a unified approach that prioritises transparency, accountability, and leadership, the NHS risks further harm to patients and families already dealing with the devastating consequences of safety failures.