Back in 2012, an independent study of NHS case notes from hospitals concluded that in about 2.3% of hospital deaths there was strong evidence that death could have been prevented. In practice, this equates to around 6,300 preventable deaths in hospitals every year.
This is a shocking statistic. As Liberal Democrats, we should never fall into the trap of talking down the NHS – our health and care services do fantastic work day after day savings lives and providing excellent care. But we must also be willing to confront fallings: every preventable death is one too many, and a tragedy.
When fatal mistakes happen, we would all say that there should, of course, be complete openness with loved ones. And the same principle should apply when a patient is harmed. But too often we hear stories of families battling to get to the truth. Sometimes clinicians close ranks. Sometimes hospital managers fear damage to their reputation. This has to be confronted.
In our 2010 Manifesto, the Liberal Democrats committed to creating a statutory Duty of Candour for hospitals, placing them under a legal duty to own up when serious mistakes are made. And Robert Francis, in his report on the lessons to be learnt from the horrors of Mid Staffordshire, also called for a statutory Duty of Candour.
I’m really pleased that the Government accepted this recommendation. Now we are consulting on whether the duty of candour should include all ‘significant harm’, covering all health and social care organisations.
In government, the Liberal Democrats have been committed to delivering better care, so everyone can be confident that they will be properly looked after by our health and care system in their moment of need. At the heart of building confidence in our system is the need for a real culture shift towards complete openness and transparency, and a commitment to learning from mistakes. This week we have made a significant step forwards in delivering on that.
Across the country, NHS trusts are being asked to “Sign up to Safety”, setting out publicly an ambitious plan to reduce avoidable harm over the next three years. In return, the NHS Litigation Authority, which indemnifies NHS Trusts against legal action, will reduce the premiums paid by those organisations which are implementing their plans successfully. Every year the NHS spends over £1.3bn on legal claims, and this plan aims to free up as much of that money as possible so it can be reinvested in providing better care.
Crucially, though, this plan won’t just apply to acute hospitals. I was determined that mental health and community care trusts were also involved – mistakes in these organisations have every bit as devastating effect on individuals and families.
As a Liberal Democrat minister, my preference has always been for encouraging local areas to find local solutions for delivering better care. Different areas have different needs, and I am glad that this new initiative will not be imposed top-down from Whitehall, but will be about supporting each NHS Trust to develop their own approach to reducing mistakes.
This new approach has the potential to make a massive difference to the thousands of families. Every mistake avoided through an obsessive focus on safety is worth it. And the lesson I learnt on a visit to the brilliant not-for-profit integrated care organisation, Intermountain Health in Utah, is that creating a really strong culture of safety saves lives, reduces harm to patients but also reduces cost so money can be reinvested in care.
In government the Liberal Democrats are working to deliver better care, building a fairer society, and reducing preventable harm is an essential step in achieving this.
* Norman Lamb MP is Liberal Democrat Minister of State at the Department of Health