Blogs

People with sensory impairment face challenges and no more so then when it comes to managing health conditions with devices that are not designed for them and medicines they have difficulty using. I have been contacted by many patients with vision or hearing loss who experience…

It is one year since I published the Hughes Report on the options for redress for those harmed by pelvic mesh and valproate. When I launched the report in Parliament on 7th February 2024, I never imagined that a year later I would…

At the heart of the National Joint Registry is an organisation that looks after the best interest of patients undergoing joint surgery. It does this by recording, monitoring, analysing, and reporting on the…

All healthcare work sometimes includes making truly difficult decisions, decisions that can have serious consequences for patients and their families, now, or in the future. This stretches from wards to Boards and into every part of the healthcare system. You only need…

Antidepressant prescribing is at record levels in England, with around one in five adults receiving these medicines for a range of mental health conditions and chronic pain. Prescriptions have…

I am the chief executive of Demos, a cross-party think tank that works to put people at the heart of policy making to improve how policy is developed as well as trust in politics. Think tanks sit outside government and are…

In 2016 the Health Quality Safety Commission (HQSC) in NZ launched a five-year programme that improved and standardised the way health care systems recognised and responded to deterioration. There were three main work streams…

Every day we have to make tough choices, balancing benefits and risks. Those choices impact on patient safety, right now or far into the future, with effects that we might have never intended or anticipated. There are too many tragedies where people…

To celebrate World Patient Safety Day, I have spoken with and learned from global patient safety leaders at the Patient Safety Movement Foundation, the World Health Organisation, the Women in Medicine International Network, and…

To celebrate World Patient Safety Day 2024, which this year focused on improving diagnostics for patient safety, I spoke with and learned from global patient safety leaders at the Patient Safety Movement Foundation, the World Health Organisation, the Women in Medicine International Network, and the HSJ Patient Safety Congress.

There is a fragility at the top of the health system, a lack of individual accountability. There is infantilisation of people who have been selected to be expert and dysfunction in the relationships between…

Enormous emphasis has been placed on patient safety in the NHS in recent years and good progress has been made, for example, through the NHS Patient Safety Strategy, which at its core seeks to improve the way…

The national implementation of Martha’s Rule is a major step forward in the commitment to improve patient safety. It is a shame that it has come about following the unnecessary tragic death of 13-year-old Martha Mills. Unfortunately, Martha and her family are not the only ones to suffer…

Patient safety is at the heart of everything we do – how often have we heard this being stated by leaders of healthcare organisations? And yet, report after report on scandals which have happened in the…

How do we make change happen at scale across a complex health system? It has been said that the best way to understand something is to try to change it. Through the sprint policy development meetings to devise the plan to make Martha’s Rule a success in England, we heard from…

The Patient Safety Commissioner’s strategy aims to ‘embed patient safety and patient voice throughout the healthcare system’. This really matters. Time and again, it is patients and families who are sounding the alarm on healthcare safety…

Getting it right for the most vulnerable means it is better for everyone. This applies as much to improving patient safety as anywhere else. We need to identify harmful events and put controls and systems in place to prevent them…

The 6th Global Ministerial Health Summit in Santiago, Chile, was a great opportunity to hear from global partners about progress in patient safety and innovations to embed patient voice…

The updated Patient Safety Commissioner strategy, which I published in January, sets out 3 main aims…

Retiring NHS Ombudsman Rob Behrens calls for a cultural transformation in the NHS so it becomes collegiate, respectful, and well-led, prioritises patient safety, and listens to patients and all who speak up for them.

HSSIB exists to investigate patient safety concerns so we can improve healthcare care at a national level. At the heart of this is a professional patient safety investigation that helps us to understand how…

For me, the principles of Type 1 diabetes and good outcomes has always based itself on three planks: self-management, peer support and access to trained professionals…

We have asked leading experts what works to improve patient safety and this is what they told us…

We have asked leading experts what works to improve patient safety and this is what they told us…

On 7th February the PSC will launch the Hughes report on redress options for those harmed by pelvic mesh and valproate. In the lead up the launch we hear from Jo Wailling about how restorative practice can heal harm.

Dr Sonia Khanom and Dr Rebecca Bromley outline new research into the impact of valproate.

Organisations who are genuinely interested in the views and experiences of patients, families, carers and the workforce can learn from these experiences. I was very encouraged by the new Secretary of State for health and social care Victoria Atkins MP who recently spoke…

Recognising good practice and seizing the opportunities to change how the NHS delivers care has the potential to make a huge impact on patient experiences and outcomes. This does not have to mean wholesale reorganisation but the NHS should embrace best practice…

It is just over a year after we appointed Dr Henrietta Hughes as our first ever Patient Safety Commissioner. She is a champion for patients and promoting their views in relation to the safety of medicines and medical devices…

In the report First Do No Harm, Baroness Cumberlege described the health system as disjointed, siloed and unresponsive.  Many changes have taken place since the publication of her report in 2020, not least the establishment of my role as the Patient Safety Commissioner…

How would you feel if your doctor offered you a treatment your health condition with good results and very little risk? You might snap it up. But what if you subsequently found out your doctor took thousands of pounds from the treatment makers to write a scientific paper promoting it…

I have recommended that NHS England set up a system for monitoring the safe use of the most potent teratogenic medications, starting with the safe use of sodium valproate in patients on a pregnancy prevention programme…

In the 16 years of my career as a medic in the pharmaceutical industry, there is one experience that has become all too familiar. I sit in an auditorium. A doctor or other healthcare professional takes the stage to present on behalf of a pharmaceutical company…

The advances in medical science are inspiring and continuing to develop at pace from the latest cancer treatments to cutting-edge surgery. We owe so much to the clinical pioneers and brave patients willing to be the ‘first’.

We often assume that new is better but when things don’t work out as hoped, it’s a different story. This is the culture of surgical innovation. Robots, gadgets, and other novel ways of operating are exciting and they generate attention. Surgeon enthusiasm for improving outcomes sweeps patients along.

My abiding memory from the WHO Global Conference ‘Engaging Patients for Patient Safety’ was the shocking experiences outlined by patients and families from across the world who had been bereaved or suffered appalling and life-changing harm.

The third in our series of blogs in the lead up to World Patient Safety Day is from Rachel Power, chief executive of the Patients Association. She reflects on progress on patient engagement and what needs to happen next.

As part of our series leading up to World Patient Safety Day, David Lawson, who leads the DHSC’s medical technology directorate, discusses how patients are influencing the strategy development.

In the lead up to World Patient Safety Day on 17 September, we are running a series of blogs from a range of experts considering different aspects of patient engagement and participation. The first is from Sue Strudwick, a Patient Safety Partner at Kingston Hospital, on involving patients in policy-writing.

I’m a medical educator and for many years I have trained doctors and other health professionals to become better listeners. Nearly all the people I have taught have thought they were good at listening but then found how to do so better.

Over the past few years, technology has been a driver for better patient care, from the proliferation of electronic medical records, continuous monitoring on general floors, to data analytics turning output from multiple inputs into useful information that can improve health, wellbeing, and patient outcomes.

As a patient, it is often hard to find patience during changes of regulation for a chronic condition. Whether it is changing medicines, doctors, time zones, or even diagnoses, finding trust in the process is inevitably challenging.

There is a consensus that improving consent will help patients understand the benefits and risks of the procedure they are considering, as well as the benefits and risks of the alternatives, including doing nothing…

Established in 1964 to protect and improve patient safety, the Yellow Card scheme is the Medicines and Healthcare products Regulatory Agency’s (MHRA) system for collecting suspected side effects or adverse incidents involving medicines, vaccines, and medical devices.

At the World Patient Safety Movement Summit at the beginning of June I had the pleasure to meet with and hear from Don Berwick, the leading authority on healthcare improvement.

‘First Do no harm’ should be the golden thread that is woven throughout all healthcare systems. Sadly, the reality is that despite the implementation of significant initiatives designed to improve systems and processes, many instances of avoidable harm still occur on a regular basis…

‘In my foreword to the report of the Independent Medicines and Medical Devices Safety Review, I did not attempt to summarise all our nine recommendations or other aspects of our review…’

‘If we listen to patients, they will give us the route map to success.  We will have better patient safety, improved staff retention and better finances…’

Imagine a world where we get the information about medicines and medical devised that we need to make the right choices about our healthcare.  And those that deliver care to us get the right information to share with us so that we give truly informed consent. 

We use our blog to talk about our work, highlight successes and share what we’re learning. Blogs are a personal way of engaging with our users, so please write as you speak, as an individual rather than an organisation or team.

My role as Patient Safety Commissioner is to promote the safety of patients in relation to medicines and medical devices and to promote the importance of listening to the views and experience of patients and the public.  But we shouldn’t need a new statutory role to tell us this – the whole system should be listening continuously to patients and acting on their feedback.

The Cumberlege report, First Do No Harm, revealed that patients did not feel heard, did not have the information needed to make the right decision about their care, could not trust the answers or that the system prioritised their and their families safety.

First Do No Harm, the independent review of the safety of medicines and medical devices led by Baroness Julia Cumberlege, found that patients’ voices were ignored, and that the health system did not listen and act, but was defensive, dismissive, and disjointed. As the first ever Patient Safety Commissioner I have been listening to patients and patient safety experts to understand what needs to improve.