First Questions to ask
Is patient safety at risk?
The National Patient Safety Agency (NPSA) (external link) has detailed guidance on levels of severity of incidents, which are graded according to the impact on patients.
- No harm
- impact prevented: any patient safety incident that had the potential to cause harm but was prevented, resulting in no harm to people receiving NHS-funded care
- impact not prevented: any patient safety incident that ran to completion but no harm occurred to people receiving NHS funded care.
- low: any patient safety incident that required extra observation or minor treatment and caused minimal harm, to one or more persons receiving NHS-funded care
- moderate: any patient safety incident that resulted in a moderate increase in treatment and which caused significant but not permanent harm, to one or more persons receiving NHS-funded care
- severe: any patient safety incident that appears to have resulted in permanent harm l to one or more persons receiving NHS-funded care.
- death: any patient safety incident that directly resulted in the death of one or more persons receiving NHS funded care.
“The effects of patient safety incidents go beyond the impact of the physical injury itself. Patients and their families may feel let down by those they trusted. The incident may also lead to unnecessary pain, additional therapy or operations and additional time being cared for in the community or in hospital.
Psychological injuries such as shock, anxiety, depression, uncertainty about recovery, fear of future treatment and disruption to work and family life are just some of the possible effects following a patient safety incident. By grading patient safety incidents or prevented incidents according to the impact or harm they cause patients, local organisations can ensure consistency and comparability of data. This consistent approach locally will enable the NPSA to compare and analyse data nationally.”
NPSA |
The NPSA national system will require the reporting of all incidents which
- led to harm, whatever level of severity, and not just the most serious
- did not lead to harm because, e.g. an error took place but it did not harm the patient
- those which did not lead to harm because an incident was prevented
- from reaching the patient, e.g. an intervention was made to stop this happening.
All this gives useful pointers for the ICAS advocate to use in assessing whether patient safety is at risk. Once this assessment is made, the ICAS advocate will need to seek advice from their line manager on the agreed procedures for contacting Trusts in these situations. Adverse incidents can also be reported anonymously by patients or their carers to NPSA (external link).
Next: What does the complainant want to achieve?
Is it realistic?
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