Month: March 2016

Global Summit

Uncategorized

The first Global Summit for Patient Safety was held in London on 9 March and 10 March.  This was an invited group of individuals in relation to patient safety discussing policy and strategy for improving safety and reducing avoidable harm with reflections from experts and ministers from across the globe.  Next year it will be held in Berlin and Margaret Chan promised that it may also coincide with an International Patient Safety Day. Day 1 highlights: […]

HEE Commission

Uncategorized

Health Education England Patient Safety Commission Report On Tuesday 8 March – during Patient Safety Week – Health Education England launched a report;  Improving Safety through education and training. This was picking up from the Berwick report and its recommendation that ‘the NHS should continually and forever reduce patient harm by embracing wholeheartedly an ethic of learning’ The recommendations: Create a culture of shared learning ensure learning from patient safety data and good practice develop and […]

Patient Safety Reporting (3)

Uncategorized

Patient Safety Reporting – the future The Patient Safety Team at NHS England – shortly to move to NHS Improvement – have been working on the ‘new’ NRLS – the Patient Safety Incident Management System (a new acronym of PSIMS). The new Patient Safety Incident Management System will: Re-engineer the current data taxonomy Review the way we capture data and the electronic forms and web interfaces Look at mobile devices and apps for data capture […]

Patient Safety Reporting (2)

Uncategorized

The National Reporting and Learning System The National Reporting and Learning System, or the NRLS as most refer to it as, was designed from around 2001 when the National Patient Safety Agency was launched.  Numerous options were considered for the collection of adverse events.  During this time the term adverse events was replaced with ‘patient safety incidents’ and the guidance ‘Seven Steps to Patient Safety’ described the levels of a patient safety incident from no […]

Patient Safety Reporting (1)

Uncategorized

The second day of Patient Safety Week was a coming together of experts related to patient safety reporting.  We were informed about the research and development work related to the current National Reporting and Learning System and about potential different mechanisms for tackling large national data systems. The work was undertaken by Imperial Patient Safety Translational Research Centre – funded by NHS England and as part of the NHS National Institute for Health Research. The report starts […]

Spotlight on Maternity

Uncategorized

Patient Safety Week started off with a launch of a ‘Spotlight on Maternity’ If an organisation commits to place a spotlight on maternity then the Government is asking that they consider these focus areas when setting out their plans. Locally-led and self-directed improvement is vital and therefore any plans and actions should also be considered in the context of local services The spotlight on maternity is a way of drawing attention to the nature and scale […]

Being constructively awkward

Uncategorized

Guest Blogger David Naylor A few years ago I interviewed six people who had a reputation for being ‘constructively awkward’. They worked in a variety of community and NHS settings and told stories that seemed to inform the attention now being paid to speaking up and the duty of candour. They told stories, for example, about confronting people in a train carriage about mobile phone use; of crewing a yacht and noticing a buoy in […]