Is Patient Safety on Life Support?

Initial thoughts by our new CEO, Paul Whiteing

February 2023

Just before I took over as Chief Executive of Action against Medical Accidents (AvMA) in January 2023, I was lucky enough to attend a Gala Dinner to celebrate the charity’s 40th anniversary. There I met the founding Chief Executive, Arnold Simanowitz OBE and the playwright, Peter Ransley. It was Peter’s play, Minor Complications, first broadcast on the BBC in 1980 which made it abundantly clear that the public were not being adequately dealt with by healthcare providers when they experienced an adverse outcome due to substandard medical care.  “Minor Complications” was a play about a woman who had a sterilisation procedure that went wrong, leaving her severely disabled. It stirred the nation when it was first broadcast and generated so many letters to the BBC that it quickly became clear there was a desperate need for something to be done to help, and hence an independent and impartial charity, AvMA was soon born.

AvMA, as a small but national charity, has a long and distinguished track record of punching above its weight in trying to effect change, speak up for patients and get policy makers to take patient safety seriously. Precise data on avoidable medical accidents is not readily available but the World Health Organization suggests that medical accidents are the 14th leading cause of morbidity and mortality across the world. Medical accidents are a significant issue.

Since starting in my role, I have been struck by the volume of media headlines about how patient safety is being compromised as the NHS goes into its next – and possibly worst — crisis.

Over the last few weeks, I have spoken to many people and organisations in and around the NHS and am getting up to speed with the healthcare landscape and, specifically, patient safety. I have been surprised by the number of experts and policy makers who, when I ask whether they think patient safety is getting better or worse overall, decline to give a straight answer and never immediately declare things are improving. Quite the opposite. Most would not want to be quoted but tell me they think it probably will get worse, not least in the short-term, as the NHS tries to cope with the deluge of people who need emergency as well as elective treatment. An NHS facing such staff shortages and well-reported staff burn-out is not going to be a place where patient safety remains a top priority. Let’s be realistic about that, and that is not to criticise NHS staff at all; it merely acknowledges the realities of the pressures they are all under.

As the new leader of a small charity which is itself facing a funding shortfall, I ask myself, is there hope? Or was I silly to take on this role? I take inspiration from the many highly committed and passionate people (beyond my staff and Trustees) I have had the good fortune to already meet, including the many campaigners, most of whom have been personally affected by a medical accident and turned their lived experience into a force for good and change. I am also immensely grateful to the many lawyers who provide pro-bono support to us. Without them, we could not provide our helpline nor provide support through our inquest service — two of our core services in much demand.

The people I’ve spoken to agree that the patient voice is critical to a well-functioning healthcare system. And all too often, despite all the talk of a just culture and Duty of Candour, I still sense that “Doctor knows best” prevails too often in healthcare. That must change.

Too often, many people still come to us confused about how to navigate the plethora of NHS bodies and related agencies just to get their questions and complaints answered. Patients need meaningful support. Yes, AvMA plays a vital part but if the Government is serious about patient safety, then it needs to effectively support patients from get-go, especially if things go wrong. If it did, it might just find that fewer of them would turn to litigation and it might spend less on lengthy public inquiries that seem to come around every 2-3 years. Inevitably, some people will need to litigate, as they have been harmed through negligence, which needs to be addressed, and they need financial help as a result.

But I did not join a charity like AvMA to wallow in self-pity about the state of things. I joined AvMA to create opportunities and to grasp the possibility of meaningful change. AvMA exists to fight for better patient safety and access to justice, and fight we will. In the process, we will also look to our friends, supporters and those who share our vision to make those possibilities realities. To finish on one of my favourite quotes: “In the end, it will be OK. And if it is not OK, then it is not the end”!