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banner Monday, 18 February, 2002, 10:40 GMT
Keeping patients safe
The overwhelming majority of doctors provide safe, high quality care for patients. Medicine, however, is not an exact science. Mistakes do and will sometimes happen. The NHS has a responsibility to ensure that it has the right systems in place to keep mistakes to a minimum and learn from them.
A wave of scandals has shaken public faith in doctors and nurses - and the government has promised a series of reforms to root out the few bad or dangerous medics.

Many of these were promised in response to the Bristol heart babies scandal - and the report of the Kennedy inquiry into the affair.

All doctors employed in or under contract to the NHS will...be required to participate in annual appraisal, and clinical audit, from 2001.

Annual checks on the skills of doctors are something welcomed by the profession as a way of spotting those whose skills are deficient or becoming out of date - before they place patients in danger.

However, the introduction of appraisal has so far been patchy.

Since April 2001, it has been compulsory to include appraisal on contracts for consultants issued in the NHS, and in theory, such appraisals should now be taking place.

GP appraisal has now been negotiated, and should be starting from April 2002.

Details of appraisal for other doctors, such as non-consultant hospital doctors, have also yet to be finalised - the government says this will happen by the end of 2002.

We are already committed to the principle of revalidation and are actively working with the GMC to introduce revalidation for all doctors.

Revalidation is an extension of appraisal - a doctor must deliver proof that he or she is competent to carry on practising in order to remain on the medical register.

The General Medical Council has overall responsibility for developing this, and does not expect to "revalidate" its first doctor before 2004.

Successful NHS appraisals will be the main element of future revalidation.

The National Clinical Assessment Authority was set up in response to criticism that the NHS was slow to react when evidence of poorly-performing or even criminal doctors came to light.

The authority started work in April - it offers advice to hospital trusts or health authorities which find themselves confronted with evidence of a problem.

It will eventually be extended to cover NHS dentists.

We will establish...a new Council for the Regulation of Health Care Professionals to strengthen and co-ordinate the system of professional self regulation

At present, NHS regulation is conducted by a range of different bodies, each looking after a particular group of professionals, such as doctors, nurses or a type of therapists.

Some of these have the legal power to prevent someone guilty of misconduct from practising, others do not have such powers.

The idea of the council was to try to create an overarching body which would try to plug any loopholes in the regulation system.

Every year, thousands of patients are harmed by accidents involving medical procedures - an example was the tragic case of Wayne Jowett, a teenager who died after having a powerful chemotherapy drug injected into his spine instead of a vein.

Ministers are concerned that hospitals are loathe to report accidents, or "near misses" - which could help other hospitals work to avoid similar situations.

They have set up the National Patient Safety Agency, which is setting up a national register of such events so that national lessons can be drawn from local mistakes.

Its targets: To double the number of "adverse incident reports" to the national register by December 2002.

On patient safety in general, the NHS is charged with delivering fewer accidents in key areas.

Spinal injection mistakes - like the one which killed Wayne Jowett, should realistically never happen again in the NHS, say ministers.

And the number of suicides of mental patients caused by hanging on non-collapsible shower rails in hospitals should also be substantially cut by March 2002, says the guidance.