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MPs' warning over patient safety incident reporting

By Lilian Anekwe

A parliamentary report on patient safety has highlighted the ‘lack of a contractual incentive' as a key reason for the NHS' failure to improve patient safety and prevent harm despite a decade of initiatives and investment.

The Health Select Committee's report on patient safety blasted the Government for ‘significant failings in current patient safety policy', calling for several issues in general practice to be ‘urgently addressed'.

The inquiry into patient safety, launched after a series of notorious lapses of patient safety including the serial killer Dr Harold Shipman, concluded there is ‘substantial under-reporting' of patient safety incidents in primary care.

General practice accounts for about 0.25% of reports each year, or around 2,000 incidents, yet up to 95% of NHS patient contacts occur in primary care – most of them in general practice.

In addition to the lack of financial incentives in the GP contract to encourage reporting, the committee speculated the reasons could include:

• Fear of litigation or prosecution: There is a perceived legal risk amongst GPs, and an increase in the rate of litigation against GPs

• Lack of an appropriate reporting system: Research suggests GPs are willing to report patient safety incidents, but reporting systems have not been adequately designed for primary care

• Lack of knowledge about how to report: Lack of reporting could be due to GPs being unaware of the communication channels

The report also highlighted primary care initiatives to improve reporting, including a collaboration between the RCGP and the National Patient Safety Agency to develop an electronic reporting system in general practice, and greater use of automated decision-support systems to make prescribing safer and help GPs to spot less common diagnoses.

Committee chair Kevin Barron MP said: ‘While we recognise and are pleased that Lord Darzi's NHS review emphasises safety, it has become clear to us that not all services are safe enough yet.

‘Our report highlights many areas where urgent action is required, in some cases where it is a life or death situation, and we urge the Government to ensure that everyone in the NHS realises that avoiding harm to patients must be their top priority.'

Health Select Committee Report on patient safety MPs have warned there is 'substantial underreporting' of patient safety incidents in primary care MPs have warned there is 'substantial underreporting' of patient safety incidents in primary care

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