One in ten
patients admitted to NHS hospitals will fall victim to
medical errors, which have now become Britain’s
fourth-biggest killer.
Medical accidents and errors contribute to the deaths of
72,000 people a year, and they are directly blamed for
40,000. They also cost the NHS £2 billion in increased
hospital stays alone.
However, fewer than a third of an estimated 900,000
annual mistakes are properly reported, an independent audit
reveals today.
The report by the healthcare research group Dr Foster
highlights both the scale of medical error in the NHS and
the extent to which the system for reporting them is
failing.
Roger Taylor, research director of Dr Foster, said:
“Compared with the transport industry, the number of errors
causing very high levels of death is extraordinary.”
Action Against Medical Accidents, a charity which helps
victims of medical negligence, said: “The research confirms
our experience of an alarming rate of errors occurring in
our NHS. The figures do not even include errors occurring in
primary care, such as in GPs’ surgeries, and are likely to
be significantly less than the actual rate as they are only
based on reported errors.
“Our experience is that all too often the health provider
does not even recognise that a mistake has been made. The
vast majority of clinical negligence claims which end up
being successful are robustly defended by the NHS.”
The Dr Foster study, which is published today in the
British Medical Journal, shows that the number of
mistakes to which NHS hospitals openly admit is a small
fraction of the total accepted by the Government’s patient
safety watchdog.
It found that only 276,514 errors were recorded each year
by English hospitals, even though the National Patient
Safety Agency (NSPA) puts the true figure at closer to
900,000.
Approximately 25 per cent of errors occur during surgery,
and another 25 per cent in diagnosis or pre-care. The other
half of all mistakes are made during treatment on the ward.
They can range from providing patients with inadequate
nutrition to prescribing the wrong dose of medication.
The figures do not include any hospital-acquired
infections or complications of childbirth, and almost 10 per
cent of the trusts surveyed claimed an unlikely error rate
of zero.
“It shows there is not enough transparency,” Mr Taylor
said. “Sometimes no one ever finds out if a patient died as
a result of something going wrong — it may never go outside
the group involved in that patient’s care.
“We need to increase pressure and encourage organisations
to make this a top priority. People would be concerned about
flying with an airline which had two crashes. That’s an
infinitessimal risk when compared with a problem of this
magnitude. It’s an absurd situation.”
Research around the world has indicated that most
hospitals have an error rate of about 10 per cent, and that
about half these incidents could have been prevented.
Dr Foster analysed more than 50 million “episodes” of
patient care, defined as a period spent under the
supervision of one doctor, and found 276,514 were recorded
as involving an adverse event. This rate of 2.2 per cent
clearly underplays the true extent of the problem, the
researchers said.
The NPSA estimates that medical errors contribute to around
72,000 deaths each year, making them the fourth leading
cause of death after cardiovascular disease, cancer and
respiratory conditions.
Male and elderly patients are the most likely to be
affected, the Dr Foster report found. Many mistakes are
caused by a bewildering range of equipment that is used in
the same hospitals: a recent NPSA study, for example, found
that most trusts use 31 different types of intravenous drip.
NHS trusts are now required to have a “no-blame”
reporting system for adverse events involving error, but
doctors and experts said this is not yet working smoothly.
Mr Taylor said: “There’s a culture of ‘well we’re all
working very hard and it’s inevitable that these things
happen’. To the public that is shocking. The only barriers
to recording this information properly are ones of will,
politics and breaking down culture. A doctor’s perception of
this problem is very different from the man in the street.”
Edwin Borman, deputy chairman of the British Medical
Association consultants’ committee, said: “These findings
are not a surprise. We have to crack this issue of reliable
reporting by introducing a true no-blame culture, which we
haven’t acknowledged yet properly in the UK. The system is
still paper-based, and it gets swamped.” Sarah Teather, a
Liberal Democrat spokeswoman on health spokesperson, said a
no-fault compensation scheme was needed if the NHS is to
make progress on the issue.
“A no-blame reporting system is no good without a
compensation system to match,” she said. “At the moment
doctors face quadruple jeopardy. They face disciplinary
action with hair-trigger suspensions, the police can get
involved, they can be referred to the GMC and there is the
prospect of tort.”
The NPSA said: “The agency welcomes this study and fully
supports the conclusion that hospitals should be encouraged
to improve the recording and reporting of adverse events.
“Only by gathering information from the widest possible
range of sources can we establish the most accurate picture
possible of patient safety issues and take steps to make the
NHS safer for patients.”
A spokesman for the Patients’ Association said: “We must
have confidence that any harm to patients is avoided but
with such poor recording, including not having specific
records for MRSA or other hospital-acquired infections, the
figures suggest the tip of a much bigger iceberg.”
