The Long Term Plan – patient safety is everyone’s responsibility

Following the announcement of NHS England's Long Term Plan earlier this month, the RCP has engaged in a week-long discussion covering the plan's most important themes. In today's blog, Dr John Dean, clinical director for quality improvement and patient safety, explains why patient safety is everyone’s responsibility.

The NHS Long Term Plan sets a positive direction including focussing on supporting community and primary care, an emphasis on integrated working,  reducing the need for urgent hospitalisation, reducing inequalities, redesigning outpatients, and enabling patients and families to take a more dominant role in their healthcare.

The commitment to building the ability of staff and organisations to continually improve services is fundamentally important to achieve this. Patient safety is to be expected, however national bodies including the government must emphasize the importance of patient safety in all strategies and plans.

We must recognise that healthcare will always have risks but it’s everyone’s responsibility to minimise risk and reflect when things go wrong. NHS Improvement’s consultation on a national patient safety strategy is a positive start. Only when each part of the system is playing its part will we make that risk acceptable and manageable.

It is imperative that the roles and responsibilities of each of the national bodies is clear and that they focus on what needs to done at a national level

Dr John D Dean, clinical director for quality improvement and patient safety

For this to be successful the NHS will need to work closely with royal colleges, patient groups and other safety experts. It is imperative that the roles and responsibilities of each of the national bodies is clear and that they focus on what needs to be done at a national level. It also needs to be clear who is 'conducting the orchestra'.

There are a number of key elements that need to happen at a national level including a framework that supports a just, open and learning culture with a focus on risk as well as harm and near misses. Adequate funding and mechanisms for the right level of staffing and essential equipment to deliver safe care as well as having a national curriculum for patient safety for healthcare staff all play their part.

Patient safety is everyone’s business and we will continue to play a leading role. We will work with national partners in the UK, influencing policy and plans; we will specifically connect and work with medical specialities to share safety practice and leadership particularly for patients with multiple conditions. We will deliver specific patient safety programmes such as the National Mortality Case Record Review Programme and provide guidance to NHS trusts and boards and their clinical leaders around patient safety.

Our guidance on Safe medical staffing, not only emphasizes levels of experience and staff numbers but also includes time for key patient related activities that improve care, including time for better communication, and to report and learn from error.

Prescribing is a significant part of their role but despite this induction processes and postgraduate teaching around safe prescribing can be variable

Dr John D Dean, clinical director for quality improvement and patient safety

Guidance on supporting junior doctors in safe prescribing shares best practice in reducing potential harm. Junior doctors are responsible for two thirds of all hospital prescriptions, and prescribing is a significant part of their role, but despite this induction processes and postgraduate teaching around safe prescribing can be variable. The guidance, we believe will lead to improved support for junior doctors and safer care for patients.

So while the NHS long term plan aims to save around 23,000 premature deaths and reduce 50,000 hospital admissions, as well as moving forward on many of the issues the RCP has long been saying. The plan also requires us to understand risks to patients’ safety in clinical care, how to manage that risk with patients and other staff, and through that to continually improve clinical outcomes, experience and sustainable care.

The challenge now is how to implement the NHS long term plan at a local level and ensure that everyone who works in the NHS and patients who use these services is clear that patient safety is everyone’s responsibility. We must all play our part to ensure its success.  

Dr John Dean is the RCP clinical director for quality improvement and patient safety

This blog is part of a week-long series of discussions focusing on the NHS Long Term Plan. If you have any questions or feedback about the topics covered in these posts please contact policy@rcplondon.ac.uk