Last week, the health secretary felt the need to create an open reporting culture, fearing that incidents were going unreported.
He is definitely right – but why? Why should staff feel afraid to raise issues when they happen, or admit mistakes have occurred? What is it about healthcare that constrains people from speaking out when something is not right?
Secretary of state for health Jeremy Hunt took the opportunity at his Global Patient Safety Summit last week to talk about the need to set up a “learning from mistakes league” and a range of other measures. See our interview with Mr Hunt here.
At Nursing Times, we’ve long said that reporting and learning from incidents should be encouraged and normalised, so you won’t find any arguments here, Mr Hunt. It’s what we have been fighting for through our Speak Out Safely campaign, which aims to make all trusts and organisations providing healthcare safer by supporting their staff to raise concerns.
Humans are fallible, as Mr Hunt quite rightly pointed out, and we must ensure we respect the fact that nurses and other health professionals will get things wrong, and must learn from that.
Cultures in other sectors have set up organisations that thrive on learning from mistakes, so what makes the NHS different?
Could it be its size? Experts believe that start-ups are energetic, boundary-less and innovative but, over a certain number of employees, the culture goes awry. Perhaps it’s the punitive, target-driven culture. Or could it be that the service is incredibly hierarchical and that challenge feels a bit too much like insubordination in many settings, or the consequences are too severe. Maybe it’s because making a mistake is still ultimately never celebrated anywhere in the NHS. In all probability, it’s a combination of these factors and more.
Could Mr Hunt be right, that the NHS culture needs to emulate that of renowned hospital Virginia Mason in the US? Incident reporting there is lauded rather than hidden; perhaps, in an NHS more like that, people would feel more inclined to ’fess up.
Unless the plethora of barriers preventing staff from speaking out are dismantled, Mr Hunt’s league table won’t work. But fixing things isn’t quite as easy as simply introducing another target and more reporting responsibilities, is it?