Patient safety is both a major global and NHS domestic problem. We all need health care treatment and the systems, staff that provide this can fail causing personal injury, death. It has been calculated that in high income countries, around 1 in 10 patients are harmed while receiving care in hospital.
Nobody is infallible and health care can be a complicated process, dependent on human skill, judgment, complex equipment and so on. Some degree of error is always going to be inevitable and the best that we can hope to do is to manage risk properly. To do this health care systems need effective governance, regulatory systems, structures to safeguard patient rights and facilitate good, safe health care practices. Laws, legislation underpin health care regulatory and governance processes in health care systems across the world.
Our new book, published in December 2023, Research Handbook on Patient Safety and the Law, Edited by John Tingle, Caterina Milo, Gladys Msiska and Ross Millar, Edward Elgar Publishing, explores patient safety policies and practices in several countries including the NHS in England. We discuss the legal interface between health regulatory, governance structures and how they relate to patient safety systems and culture development. There are 22 chapters in the book, and they include from Birmingham Law School:
-Chapter 2, ‘The Need for More Conceptual Underpinning in NHS Patient Safety and Clinical Negligence policy development by John Tingle.
-Chapter 4, ‘Non-therapeutic Clinical Research with Children: Responsibility in the Balance?’ by Amber Dar.
-Chapter 7, ‘Healthcare in Conflict: Legally Protected, Physically at Risk’ by Emma Breeze.
-Chapter 21, ‘Dr Robot: Robotics and AI in Healthcare’ by Angela Eggleton.
The book is multidisciplinary in nature with chapters written by legal, social policy, health development academics, policy makers, and clinicians from countries across the world. We explore the context of health care delivery in several countries including the NHS in England to evaluate the efficacy, effectiveness of health regulatory, governance frameworks. Countries discussed include Australia, Germany, Uruguay, Portugal, Malawi along with others.
How health regulatory, governance structures, redress, compensation systems are perceived by clinicians, patients and policy makers are explored in our book. Defensive clinical practices, poor adverse incident reporting rates can result through the fear of a doctor or nurse being sued.
Common themes are drawn together in the concluding chapter of book. Patient safety is still a developing academic discipline across the world. In relation to the NHS in England, history has not served it well in terms of patient safety culture development. The lessons of many past patient safety crises in the NHS have gone unlearnt and the same errors can be seen to be repeated.
Global progress towards patient safety culture development can be seen to be incremental, piecemeal in nature, and that much more needs to be done. The law can be seen to have a key role to play in patient safety culture development, setting the tone, flavour of regulatory, governance and dispute resolution mechanisms. More conceptual underpinning, understanding of the role of law needs to take place when policy makers and governments discuss the relationship it has with patient safety culture development. Through our book we have hopefully provided a blueprint and agenda for national NHS and global patient safety change and development.