Select Committee on Health Written Evidence

Memorandum by Adrian Delemore (PS 53)


  The Committee has decided it will undertake an inquiry into patient safety. The inquiry will focus on:

2.   What the current effectiveness is of the following in ensuring patient safety:

d.   the National Patient Safety Agency and other bodies

  The current remit of the NPSA is to address patient safety issues largely divorced from issues of deliberate wrongdoing. (This constriction may well also apply to other official bodies charged with responsibilities in respect of patient safety.) Consideration of wrongdoing, whether by clinicians or otherwise, is viewed as a matter for the criminal law and the police. This is highly unsatisfactory as it is frequently the case that issues of patient safety and of deliberate wrongdoing are linked and interwoven such that it is contrived and misguided to consider these issues entirely separate. What starts perhaps as a very human error of judgement by a clinician can become obfuscated and concealed by falsification of medical records and other acts of wrongdoing. Such acts often anticipate a complaint by a patient, and can seek to undermine a patient's credibility. I have spoken to many people who have found the NHS complaint procedures wanting (many would say corrupt), and this pattern of an adverse incident or experience followed by wrongdoing, usually involving record falsification and often having the effect of undermining a patient's credibility, has frequently become apparent. Indeed, from the patient perspective it can be the worst aspect of the whole experience because it cuts at the foundations of entrusting one's safety to healthcare services.

  There is a need to develop the investigative techniques that may uncover attempts to conceal truth, or/and to unfairly or improperly cast doubt on a patient's credibility. The NPSA and other such official bodies charged with responsibility for patients safety issues should not be constricted in their investigation and should be supported in developing appropriate forensic techniques to address issues of deliberate wrongdoing.

September 2008

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