The National Harm Service? Do NHS blunders cause 8 deaths a day?
21st Jun 2013
Since becoming Secretary of State for Health, Jeremy Hunt has had to deal with one crisis after another.
Yesterday the Care Quality Commission, the agency in charge of assessing the safety of hospitals and care homes, was described as like a "fish rotting from the head". And today, citing statistics that show the incidence of harm in NHS hospitals, Mr Hunt made a speech in which he promised that the Government would confront the "silent scandal" of patient harm.
A headline in today's Daily Mail offered a stark assessment of the current reality: "NHS blunders cause eight deaths a day".
However, it's not easy to measure patient harm. And while it's likely that many incidents go unreported, it's questionable whether the problem is of scandalous proportions. According to figures that Mr Hunt himself cites, last year only 0.4% of NHS patients suffered harm.
Nevertheless, when you're talking about a health service that treats one million people every 36 hours, that's 500,000 people "harmed unnecessarily" in 2011/12. Approximately 3,000 patients (0.003%) died.
The Department of Health (DH) says that these statistics are based on a sample of 100 million in-patient, out-patient and A&E attendances in 2011/12. Although we can't access national-level data, NHS England does publish patient harm reports for individual NHS trusts.
Crucially, this system relies on NHS trusts voluntarily reporting incidents of harm. A DH spokesperson said that the number of reports received "continues to increase over time" and it interprets this as "a good sign of an increasingly embedded patient safety culture."
DH wants more NHS trusts, more hospitals and more doctors to publish data on how well they're performing. The idea is that greater transparency will help improve patient outcomes - it is, in effect, a way of naming and shaming.
Some patient safety incidents are so serious that, in theory, they should never be allowed to occur. These 'never events' include a surgeon operating on the wrong part of somebody's body or a doctor administering an incorrect dose of medication. As Mr Hunt noted, 'never events' do happen.
In 2011/12 there were 326 'never events'. We don't know how this number compares to previous years because this year the 'never event' list incorporated 17 new categories. This is part of the Government's drive to improve the reporting of harmful incidents. In his speech Mr Hunt admitted that the official figures are likely to underestimate the true scale of the problem.
However, this graph from the the Commonwealth Fund shows how the UK compares with other countries for one particular 'never event' - a surgeon leaving a swab, a guidewire or a part of a surgical instrument inside a patient's body.
More up-to-date data from the Commonwealth Fund reveals that when it comes to patient safety the NHS compares favourably with other economically developed countries. In 2011 only 8% of UK adults had experienced a "medical, medication or lab test error in the past two years" - the lowest percentage among the nations surveyed, which included France, Sweden and the US.
By addressing concern about patient harm, Mr Hunt may be trying to show that the Government is determined to be honest about the NHS's failings. As more incidents are reported, we're likely to see an increase in the number of patient harm incidents, and potentially, a corresponding rise in the number of 'never events'.
It's worth remembering - as Mr Hunt notes - that for patient safety the NHS outperforms the health services of other countries. This might be partly due to the fact that harmful incidents are going unreported, but as it stands, the official figures suggest the NHS is relatively safe for patients.