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In a publicly funded healthcare system, what role do politicians have in setting culture and improving patient safety?

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A question posed by a delegate at our Patient Safety Learning conference 2019:

'In a publicly funded healthcare system, what role do politicians have in setting culture and improving patient safety?'

What are your thoughts? 

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A very intersyting question from our conference and especially so in the run up to the general election. NHS Providers CEO, Chris Hopson, has today called on all political parties not to use the NHS as a 'political; waepon.'

Politicians have a huge impact in a state funded system - from setting priorities, agreeing funding and clearly setting the culture within which everyone works. I wonder whether there has been formal research undertaken on this? Does anyone know - whether in the UK or internationally?

A few initial reflections/comments/questions:

- Never events are a concept much loved by politicians and leaders as it shows that they are taking things seriously and and can respond to unsafe care with 'something must be done' investsigations. But does this concept help people's understanding of the complexity of care. And indeed, why are some events 'never' and others not?

- Politicians vary in their interest and bravery when it comes to patient safety. Jeremey Hunt commisioned some significant inquiries into unsafe care and organisational failure. Will others do so?

- What evidence is there of political committment to implement recommendations from multiple reports and inquiries that affect patient safety? From Bristol Heart, Mid Staff, Morecambe Bay, Liverpool Community and many more...can we say that politicians have driven change and improvement?

The All Party Parliamentary Group on Patient Safety hasn't been active for a while now. Post election, aren't these issues ones that they should be addressing?

Comments/discusison welcome.

@Mark Hughes

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It would be interesting to look in more detail at how politicians have engaged with patient safety in recent years, my suspicion would be that outside of the specific reports from regulators and major incidents such as the Mid-Staffs Inquiry it has been on quite an ad-hoc basis.

From a parliamentary perspective, a quick review of Hansard seems at first to suggest a low level of engagement, revealing that there have been only 4 debates on patient safety (3 in 2014, 1 in 2018) and 47 written ministerial statements in the last ten years.  However there have been numerous debates on issues such as dispensing errors, safety of medical devices and major incidents, so the main challenge may be harnessing these to help draw attention towards the bigger picture and need for changes at a system level.

Aside from the top down down role politicians have in setting priorities for the health care system they can also provide a conduit for increased patient engagement and input. If politicians can make the case for patient safety, providing a spotlight for their constituents in cases where mistakes are made and/or learning subsequently implemented, this could be really beneficial. An active All Party Parliamentary Group would certainly be one way of doing this, providing a platform for sharing stories and highlighting good and bad practice.

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Completely agree with that, Mark. The main challenge may be harnessing these to help draw attention towards the bigger picture and need for changes at a system level

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