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Trusts ranked in new 'learning from mistakes' league table

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The Department of Health has published a “learning from mistakes league”, ranking all trusts on their “openness and honesty” based on data on safety reporting and the NHS staff survey.

The new table, the creation of which will be highlighted today in a speech by the health secretary, splits trusts into four divisions – those with “outstanding levels” of openness and transparency, those which are “good”, those which have “significant concerns”, and those with a “poor reporting culture”.

Data for 2015-16, which is drawn from the 2015 NHS staff survey and from the National Reporting and Learning System, shows that:

  • 18 providers were outstanding
  • 102 were good
  • 78 gave cause for significant concern
  • 32 had a poor reporting culture

At the bottom of the rankings is East Sussex Healthcare NHS Trust, which is placed at number 230 in the table.

Other trusts deemed to have a “poor reporting culture” include Royal Cornwall Hospitals NHS Trust, Medway NHS Foundation Trust, Heart of England NHS Foundation Trust, Barts Health NHS Trust and St George’s University Hospitals NHS Foundation Trust.

The table is topped by Northumbria Healthcare NHS Foundation Trust, followed by Oxleas NHS Foundation Trust, The Royal Marsden NHS Foundation Trust, Tees, Esk and Wear Valleys Foundation NHS Trust, and Salisbury NHS Foundation Trust.

Others with “outstanding levels” include Wrightington, Wigan and Leigh NHS Foundation Trust, Tameside Hospital NHS Foundation Trust and Cambridgeshire Community Services NHS Trust.

The sections of the NHS staff survey that have contributed to generating the rankings include fairness and effectiveness of procedures for reporting incidents, staff confidence in reporting unsafe practice, and how confident staff feel in contributing to improvements.

Department of Health

Trusts ranked in ‘learning from mistakes’ league

Mike Durkin

The Department of Health said the data could could not be used to identify “cover ups”, but said those at the bottom of the league would have to look at their reporting practices and work with staff on these issues.

Mike Durkin, national patient safety director at NHS England, said: “Learning from mistakes saves lives. In order to properly learn from mistakes we need to create a culture with openness and transparency at its heart.

“By letting trusts know how well they are doing compared with their peers, we want to start a conversation involving clinicians, managers and supporters of the NHS about what we can all do to make all parts of the NHS as safe as they can be,” he added.

Professor Sir Mike Richards, the Care Quality Commission’s chief inspector of hospitals, said: “We welcome this new commitment to embedding an open and learning culture in NHS hospitals.”

“There is a real risk that this approach will start the conversation in the wrong place”

Rob Webster

But Rob Webster, chief executive of the NHS Confederation, which represents health service managers, said the government’s continuing focus on transparency must be matched by a “responsible approach to data with appropriate communications that allow for the right interpretation to be made”.

Mr Webster claimed that the creation of the new “league table and crude ratings” failed on both of these counts.

“If the intention is to recognise that data can help begin a conversation that prompts reflection, learning and action, then there is a real risk that this approach will start the conversation in the wrong place,” he said.

“The consequence is that learning will be lost in the heat of the crude ratings rather than exposed in the light of new insight and curiosity,” he added.

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