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Watchdog warns of GP safety data 'black hole'

By Gareth Iacobucci

The Healthcare Commission has warned of a ‘black hole' of information on the quality and safety of general practice.

Launching the commission's annual report, its chairman Sir Ian Kennedy said research into safety in GP practices suggested incidents were far more common than actual data showed, and warned of a ‘black hole' of information.

While 7,660 cases of severe harm and 3,471 deaths were reported to the National Patient Safety Agency last year, these significantly underestimated the real number of incidents in general practice settings, he added.

Just 0.3 per cent of nearly 960,000 reported incidents – including mistakes and missed diagnoses - were from general practice.

The report highlighted research suggesting that medical errors occured in primary care up to 80 times per 100,000 consultations - equating to between 40 and 600 errors a day.

Sir Ian said there was an urgent need for closer scrutiny and more accurate reporting of incidents in primary care.

‘The vast majority of that care is safe and of good quality, but that's as far as we can go.

‘What must change is that we currently don't know very much about how safe care in primary care is. Information about missed diagnoses or late diagnoses won't show up in anyone's register of events, because there is just a black hole.'

He added: ‘We've got to get it internalised, so a GP practice understands it is following good practice [by reporting incidents], as well as untoward incidents and things missed.'

But the BMA said the findings, taken from 2007/08, were out of date and misleading.

Dr Hamish Meldrum, chairman of the BMA, said: ‘Unfortunately, the report contains the misleading suggestion that up to 600 errors occur in primary care a day. This is based on data which was mainly gathered outside the UK, and identified that medical error occurs between five and 80 times per 100,000 consultations.

‘Any errors are regrettable but there are millions of contacts between the NHS and patients every day. It is inevitable that, in a very small proportion of these, care falls below the highest standards.

‘Doctors want to get rid of unacceptable variations in quality, but we need to be careful to analyse and learn from the causes of low performance rather than jumping to conclusions or simply adopting a blame culture.'

This year's State of Healthcare report is the Commission's last before it disbands and hands over its work to the new Care Quality Commission (CQC) in March 2009.

Sir Ian Kennedy, chairman of the Healthcare Commission, warned of 'black hole' in data on GP safety Sir Ian Kennedy: warned of 'black hole' in data on GP safety

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