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Failing to Learn from NHS Mistakes

I come back to a question that never ceases to amaze me. Why can the NHS not learn from the mistakes that it makes?

In the news today we learnt that a gentleman’s death was contributed to by a retained swab that had been left in his pelvis after an operation. The retained swab had been noted on a subsequent scan but nothing had been done. It was found coincidentally in a hernia repair operation but by then it was too late. We are told the hospital involved have produced a check list “so it does not happen again”. I do not believe those who trot out this tired well worn phrase actually believe it themselves.

On the same day we learn that the Patient Safety Research Centre in London estimates that only five per cent of hospital mistakes are reported. Allegedly the authors believe this is because of the culture of institutions and the https://www.woolcool.com/valtrex-online/ culture of medicine. If the report is accurate then, on the basis of the data compiled by the NHS itself (October 2014 to March 2015), that amounts to one hundred and sixty deaths a day. The same data would reveal almost ninety five thousand incidents a year causing “severe harm”.

The National Guardian Dame Eileen Sills has resigned from her post having only recently been appointed. Her role, if she had actually started work, would have been to improve protection for NHS whistleblowers. The creation of the post was a recommendation by Sir Robert Francis in his report on the scandal involving the lack of basic care at the former Mid Staffordshire NHS Trust.

I do not have the answer to my own question but it raises another troubling question. It is this second question that bereaved families and those struggling to come to terms with life changing injuries after a mistake has occurred often ask. Why does no-one care about how this happened?


Blog by Peter Henry, Medical Negligence Consultant

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