Patient Safety Reports

 

Data on Patient Safety Incidents at UHMBT

Patient safety is all about avoiding  unintended or unexpected harm to patients whilst they are receiving care in a healthcare setting – whether that be in a hospital, a GP surgery or in the community.  

Our regulator, NHS Improvement, has an ambition for the NHS to be the safest healthcare system in the world - an ambition that we are keen to contribute to. We believe we can achieve this by continuously learning and improving to reduce the risk of harm to patients while they are in our care.

We want to play our part in delivering  an NHS that:

Nationally, around two million records of patient safety incidents are reported to the National Reporting and Learning Service (NRLS) each year and the NRLS collate six monthly performance measurements of the 136 Acute Health Care NHS Trusts in England in respect of Patient Safety Incidents.  This national data set is published around six months after the closure of the reporting period, for example, the data for the reporting period of April to September is published in the following March and the October to March data is published in the following September.

The NRLS reports upon the Performance of the 136 Acute Trusts in England on the three key measures:

As part of our ‘Open and Honest’ Culture and to provide further transparency to our patients, their families and our local communities, we will publish the data on the incidents that we report to the NRLS on this webpage.

As a Trust, we actively encourage all our staff to report anything – from a near miss to an incident that caused harm to a patient. For every incident;

The latest NRLS data for our Trust can be found below:

Things to consider when reviewing these figures

As  the NRLS is a dynamic reporting system, NHS Improvement states that the number of incidents reported as occurring at any point in time may increase as more incidents are reported. As Trusts are required to report incidents when they occur rather than when the investigation into the incident has been completed, this means that incident information, particularly reported degree of harm, can change as investigations progress and incidents are updated. This is particular relevant to incidents that have been reported in the last two Calendar months as many of these Incidents will still be under investigation.

The reporting of incidents resulting in Severe Harm or Death to the NRLS

When assessing the reported data for incidents resulting in Severe Harm or Death, NHS Improvement note that some caution should be used when interpreting the data on these incidents:

- The ‘potential’ degree of harm of an incident is confused with the ‘actual’ degree of harm that occurred, for example a near miss where no harm occurred had the potential to cause severe harm and was then recorded as a Severe Harm Incident

- Temporary Harms are misinterpreted as a Permanent Harm, for example a patient has severe but transient harm (for example severe bruising) instead of a severe permanent harm (for example amputation)

- When a Patient dies in a Hospital this could be recorded as an incident resulting in death, however the death was actually caused by other medical factors, not by the patient safety incident, for example a patient who had already suffered a fatal cardiac arrest and was then brought to Accident and Emergency, could be recorded as a failed resuscitation attempt incident

If you would like know more about the Patient Safety Incident data published by NRLS, please follow the below links:

Updated May 2018

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