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With recent research showing that up to 237 million drug errors may be being made every year, should the government be doing more about the harm that is being caused?
The research that has been published by Manchester, York and Sheffield Universities shows that health care providers may be making 237 million errors a year, a staggering amount. And with 1.15 billion drug prescriptions being made each year, this is the equivalent of one mistake made for every 5 drugs handed out.
Whilst most of these errors caused no ill effects, it has been noted that in a significant number of cases the harm caused can be broken down as follows:
A fifth of the mistakes related to hospital care, including errors made by doctors administering anaesthetic before surgery, whilst the rest were fairly evenly split between drugs given in the community by GPs and pharmacists, and those handed out in care homes.
Whilst it must be noted that these statistics are based upon research going back a number of years, due to limited data being available in this area, they are of the opinion that the findings are robust enough to warrant action.
So much so that the Health Secretary, Jeremy Hunt, has addressed these findings in the media and is of the opinion that drug errors in England are causing appalling levels of harm and death.
When speaking to the BBC, Mr Hunt said: “We are seeing four to five deaths every single day because of errors in prescription, or dispensing, or the monitoring of medications.” He added that the study was not about blaming NHS staff, but about creating a culture where checks were in place to stop errors happening.
So with Mr Hunt and the Department of Health acknowledging this problem what changes are being proposed to reduce the amount of errors being made and to improve patient safety?
At the time of writing this blog Mr Hunt was due to give a speech to a patient safety conference in London on Friday 23 February 2018, to outline the steps the NHS is taking to reduce mistakes.
It is understood that his proposed recommendations are as follows:
1 – Hospitals having access to prescribing data from the patient’s GP
Under Mr Hunt’s plans, hospitals will be able to access prescribing data collected by an admitted patient’s GP to see if any of the drugs they have been taking have led to them being admitted to hospital.
Initially that will involve only patients being treated for gastro-intestinal bleeding, which can cause harm or death. The treating doctors will be able to check, for example, if a patient has been taking a non-steroidal anti-inflammatory drug but not been given another drug to reduce the chances of them suffering digestive bleeding. The system will be extended later to other conditions.
2 – The continued rollout of electronic prescribing
At present only a third of hospitals have an effective system in place. By introducing this system more widely the Department of Health and Social Care believe this could reduce prescribing errors by 50%.
3 – Greater openness about mistakes
Mr Hunt has expressed the view that it is only being open about the mistakes that are being made in order for the NHS to be able to learn from them and improved the safety of the services they are providing to patients.
4 – Decriminalising dispensing errors
Previously pharmacists have been able to be prosecuted for making dispensing errors. However, a change in the law will now be introduced to prevent pharmacists from being prosecuted through the criminal courts, if they own up to genuine mistakes that have been made.
Whilst welcoming Mr Hunt’s initiatives, Professor Helen Stokes-Lampard, of the Royal College of GPs, has stated that doctors “work hard to avoid making mistakes” but were only human.
Prof Stokes-Lampard further noted that the “intense pressures” on the front line would also be contributing to the problem and advised: “The long-lasting solution to this is a properly funded NHS with enough staff to deliver safe patient care.”
This was a view shared by Janet Davies, the chief executive of the Royal College of Nursing chief executive Janet Davies who stated: “There is real problems in preserving patient safety when you haven’t got enough staff and when we’ve got the financial pressures we have.” She said human error is “one of the biggest risks” and that overstretched nursing staff and agency workers put “added risk in” the system, but certainly did not make errors inevitable.
It is clear that Mr Hunt and the health professionals who have commented upon this research acknowledge the problems we are facing, in that such errors need to be reduced, but there seems to be a general stance that these errors are mistakes that result from overworked and underfunded services.
Whilst these are of course pertinent concerns, and ones that are ever present in today’s NHS, it is also important to look at the impact such errors have on the individuals who are on the receiving end of these.
For each individual that falls victim to a drug error, a life can be changed forever, or even lost. It must be remembered that these lives are those of individuals rather than statistics on a page.
Whilst this is not an entirely new problem, the publication of this research has brought the issue back into the spotlight. Hopefully this is what is needed to push the Department of Health to make real changes to reduce the occurrence of these problems. Whether the changes proposed by Mr Hunt will be enough remains to be seen, though.
What will no doubt continue to concern individuals who have suffered such drug errors is their ability to recover compensation for the injuries that have been caused to them as a result of negligence. Especially with the ongoing plans for fixed recoverable costs in clinical negligence claims, an idea which was also coincidentally put forward by the Department of Health.
Under these proposals, for which there has already been a consultation and a working party put in place to report back to the Government by the end of September, solicitors’ fees will be capped for claims under £25,000. This is something that could lead many firms to avoid claims of this value. Nearly all drug error claims will fall below this limit so access to justice for those affected could well be made that much more difficult.
Whilst the Department of Health’s proposals to reduce the amount of drug errors are admirable, are they actually considering the harm they cause to individuals, or just the harm they cause to the NHS? It should not be the case where patient safety and access to justice are diametrically opposed concepts – but unfortunately the Department of Health have yet to grasp this concept, it appears.
If you have experienced any issues with drug errors made by your medical professional or pharmacist and are concerned that you have been caused harm as a result of this please contact a member our specialist team using the details below. We will be happy to answer any queries you have.
We remain committed to patient safety and are always happy to receive enquiries of this nature, and will continue to do so despite the government’s plans to introduce fixed legal costs as we believe that an individual’s access to justice should never be compromised no matter how small the harm is perceived to be.