NHS urged to back plan to help patients harmed by mistakes

Patients and families who suffer avoidable harm as a result of mistakes in the NHS should be given targeted help and support to recover.

Campaign group the Harmed Patients Alliance and patient safety charity Action against Medical Accidents (AvMA) believe the NHS needs to develop a specific harmed patient pathway to care for families affected by errors in their care.

They are hoping to define what the pathway will look like in partnership with families, patients and NHS trusts with the idea of piloting an approach in the NHS and getting it adopted nationally.

There are more than two million safety incidents reported in the NHS every year, with more than 10,000 incidents resulting in severe harm and death.

Joanne Hughes, whose daughter Jasmine died at Great Ormond Street Hospital a decade ago after mistakes in her care, believes patients and families are being left with psychological, emotional and moral injuries that persist for years.

Ms Hughes, who set up the Harmed Patients Alliance with maternity safety campaigner James Titcombe, told The Independent the NHS needs to acknowledge its responsibility to harmed families.

She said: “So many people are suffering and don’t have the support to cope and recover. We need the system to recognise that.

“The NHS will consider a physical injury or a bereavement, but it fails to consider the injury that happens when people are harmed by healthcare and that that requires some input to enable people to recover fully from it.

“Being harmed as a result of an error puts people into systems and processes. like investigations, that they would not be part of if they hadn’t been harmed, and these processes can be injurious themselves.”

Under the proposed harmed patient pathway, those who suffer avoidable errors would be assessed and their needs recorded. This could include being meaningfully engaged with investigations into what went wrong, access to independent advocacy services, specialist counselling and being involved in helping organisations learn from their mistakes to improve safety.

Peter Walsh, chief executive of AvMA, which offers help and advice to patients affected by safety errors, added: “The impact of lapses of patient safety on patients and their families is fairly well known, but untold ‘second harm’ is caused by the way the system responds and fails to support the people affected. This has to stop.

“We are calling on government and the NHS to commit to specific measures in a harmed patient pathway to do just that.”

The NHS is already subject to a formal duty of candour when a serious incident happens. This requires hospitals to apologise to patients and investigate the incident but repeated inquiries have found the NHS fails to properly learn from errors and does not involve patients in investigations.

The clinical negligence system in the UK has also been blamed for encouraging hospitals to be defensive over incidents and forces families to bring costly legal claims which can take years to resolve.

The Harmed Patient Alliance and AvMA said the adoption of a defined harmed patient pathway would help the NHS to develop a “just culture” which was being promoted by the NHS patient safety director Aidan Fowler as part of his strategy for the NHS before the pandemic.

Under a just culture approach, organisations don’t seek to blame individuals for what went wrong but acknowledge what happened and try to understand why it happened, what were the systemic causes and what the patient and staff need to recover.

The NHS has been persistently criticised for its “blame culture” in recent years after a number of safety scandals in patient care.

National director of patient safety, Aidan Fowler, said: “While patient safety incidents are thankfully rare, when they do occur, we expect staff to be able to discuss these openly among their teams and with family members of the patient.

“The NHS is already piloting a new framework to help organisations in their response to patient safety incidents and this includes supporting patients and their families following an incident and throughout any investigation.”

The Harmed Patient Alliance can be reached at info@harmedpatientsalliance.org.uk