Other reports and inquiries

Articles in this category

1. Independent investigation into birth of stillborn baby at HMP Styal on 18 June 2020: A report by the Prisons and Probation Obudsman (11 January 2022)

   • Prison
   • Maternity
   • (and 4 more)

     Tagged with:

     • Prison
     • Maternity
     • Investigation
     • Baby
     • Patient death
     • Womens health

   By Patient-Safety-Learning, 12 January

   • 0 comments
   • 153 views
   • 
   • Added by Patient-Safety-Learning
   • 12 January

2. Government response to the independent inquiry report into the issues raised by former surgeon Ian Paterson (16 December 2021)

   • Surgeon
   • Patient harmed
   • (and 5 more)

     Tagged with:

     • Surgeon
     • Patient harmed
     • Recommendations
     • Patient safety incident
     • Criminal behaviour
     • Flawed processes
     • Private sector

   By Mark Hughes, 16 December, 2021

   • 0 comments
   • 170 views
   • 
   • Added by Mark Hughes
   • 16 December, 2021

3. West Suffolk Review (9 December 2021)

   • Investigation
   • Whistleblowing
   • (and 4 more)

     Tagged with:

     • Investigation
     • Whistleblowing
     • Speaking up
     • Policies / Protocols / Procedures
     • Organisational culture
     • Culture of fear

   By Patient Safety Learning, 10 December, 2021

   • 0 comments
   • 223 views
   • 
   • Added by Patient Safety Learning
   • 10 December, 2021

4. Misconduct in public office. Why did so many thousands die unnecessarily? Report of the People’s Covid Inquiry (1 December 2021)

   • Investigation
   • Pandemic
   • (and 6 more)

     Tagged with:

     • Investigation
     • Pandemic
     • Virus
     • Organisation / service factors
     • Recommendations
     • Contributing factor
     • Patient death
     • Patient / family involvement

   By Patient Safety Learning, 2 December, 2021

   • 0 comments
   • 162 views
   • 
   • Added by Patient Safety Learning
   • 2 December, 2021

5. No one's listening: an inquiry into the avoidable deaths and failures of care for sickle cell patients in secondary care (APPG on Sickle Cell and Thalassaemia, November 2021

   • Investigation
   • Medicine - Haematology
   • (and 7 more)

     Tagged with:

     • Investigation
     • Medicine - Haematology
     • Training
     • Racism
     • Health inequalities
     • Health Disparities
     • Accident and Emergency
     • Hospital ward
     • Sickle cell

   By Patient Safety Learning, 15 November, 2021

   • 0 comments
   • 327 views
   • 
   • Added by Patient Safety Learning
   • 15 November, 2021

6. Early Day Motion - Government response to the recommendations of the First Do No Harm report (21 October 2021)

   • Medical device
   • Medication
   • (and 5 more)

     Tagged with:

     • Medical device
     • Medication
     • Maternity
     • Recommendations
     • Epilepsy
     • Patient harmed
     • Womens health

   By Mark Hughes, 25 October, 2021

   • 0 comments
   • 226 views
   • 
   • Added by Mark Hughes
   • 25 October, 2021

7. Coronavirus: lessons learned to date, examining the initial UK response to the covid pandemic (12 October 2021)

   • Virus
   • Pandemic
   • (and 5 more)

     Tagged with:

     • Virus
     • Pandemic
     • Vaccination
     • Infection control
     • Social distancing
     • Social Care
     • Emergency medicine

   By Patient Safety Learning, 12 October, 2021

   • 0 comments
   • 532 views
   • 
   • Added by Patient Safety Learning
   • 12 October, 2021

8. Independent Maternity Services Oversight Panel: Thematic Stillbirth Category Report (September 2021)

   • Maternity
   • Baby
   • (and 3 more)

     Tagged with:

     • Maternity
     • Baby
     • Patient death
     • Investigation
     • Recommendations

   By Patient Safety Learning, 6 October, 2021

   • 0 comments
   • 289 views
   • 
   • Added by Patient Safety Learning
   • 6 October, 2021

9. Independent investigation into the death of Baby A at HMP Bronzefield on 27 September 2019: A report by the Prisons and Probation Obudsman

   • Prison
   • Maternity
   • (and 5 more)

     Tagged with:

     • Prison
     • Maternity
     • Investigation
     • Baby
     • Patient death
     • Pregnancy
     • Womens health

   By Patient Safety Learning, 22 September, 2021

   • 0 comments
   • 378 views
   • 
   • Added by Patient Safety Learning
   • 22 September, 2021

10. Nimrod XV230: 15 years on (2 September 2021)

    • Aviation
    • Investigation
    • (and 3 more)

      Tagged with:

      • Aviation
      • Investigation
      • Organisational learning
      • Human factors
      • Leadership

    By Patient Safety Learning, 21 September, 2021

    • 0 comments
    • 175 views
    • 
    • Added by Patient Safety Learning
    • 21 September, 2021

11. Lessons learnt from accidental and unintended exposure to ionising radiation events notified to HIQA in 2020 (15 September 2021)

    • Investigation
    • Radiologist
    • (and 6 more)

      Tagged with:

      • Investigation
      • Radiologist
      • Patient harmed
      • Recommendations
      • Diagnosis
      • Human error
      • Human factors
      • Ireland

    By Patient Safety Learning, 16 September, 2021

    • 0 comments
    • 180 views
    • 
    • Added by Patient Safety Learning
    • 16 September, 2021

12. A year on from the Cumberlege Review: Initial reflections on the Government’s response (Patient Safety Learning, 23 July 2021)

    • Medical device
    • Medication
    • (and 5 more)

      Tagged with:

      • Medical device
      • Medication
      • Maternity
      • Recommendations
      • Epilepsy
      • Patient harmed
      • Womens health

    By PatientSafetyLearning Team, 26 July, 2021

    • 0 comments
    • 694 views
    • 
    • Added by PatientSafetyLearning Team
    • 26 July, 2021

13. Government response to the report of the Independent Medicines and Medical Devices Safety Review (21 July 2021)

    • Medical device
    • Medication
    • (and 6 more)

      Tagged with:

      • Medical device
      • Medication
      • Maternity
      • Recommendations
      • Pregnancy
      • Patient harmed
      • Womens health
      • Epilepsy

    By Mark Hughes, 22 July, 2021

    • 0 comments
    • 1,223 views
    • 
    • Added by Mark Hughes
    • 22 July, 2021

14. Independent Report of the Patient Reference Group – response to the report of the Independent Medicines and Medical Devices Safety Review (21 July 2021)

    • Medical device
    • Medication
    • (and 6 more)

      Tagged with:

      • Medical device
      • Medication
      • Maternity
      • Recommendations
      • Pregnancy
      • Patient harmed
      • Womens health
      • Epilepsy

    By Mark Hughes, 22 July, 2021

    • 0 comments
    • 690 views
    • 
    • Added by Mark Hughes
    • 22 July, 2021

15. House of Commons Debate - Independent Medicines and Medical Devices Safety Review (8 July 2021)

    • Medical device
    • Medication
    • (and 5 more)

      Tagged with:

      • Medical device
      • Medication
      • Maternity
      • Recommendations
      • Pregnancy
      • Patient harmed
      • Womens health

    By Mark Hughes, 9 July, 2021

    • 0 comments
    • 450 views
    • 
    • Added by Mark Hughes
    • 9 July, 2021

16. West Midlands Ambulance Service: Patient delayed on the back of an ambulance resulted in significant deterioration and ultimately death of patient (May 2021)

    • Deterioration
    • Ambulance
    • (and 1 more)

      Tagged with:

      • Deterioration
      • Ambulance
      • Patient death

    By Patient Safety Learning, 28 May, 2021

    • 0 comments
    • 195 views
    • 
    • Added by Patient Safety Learning
    • 28 May, 2021

17. National Medical Examiner’s report 2020

    • Medical examiner
    • Patient death

    By PatientSafetyLearning Team, 29 April, 2021

    • 0 comments
    • 461 views
    • 
    • Added by PatientSafetyLearning Team
    • 29 April, 2021

18. House of Lords Debate - Independent Medicines and Medical Devices Safety Review: Sodium Valproate (2 March 2021)

    • Patient harmed
    • Investigation
    • (and 2 more)

      Tagged with:

      • Patient harmed
      • Investigation
      • Maternity
      • Patient safety incident

    By Mark Hughes, 3 March, 2021

    • 1 comment
    • 540 views
    • 
    • Comment by Steve Turner
    • 3 March, 2021

19. First Do No Harm APPG meeting: Answers from the Minister to questions raised

    • Investigation
    • Womens health
    • (and 5 more)

      Tagged with:

      • Investigation
      • Womens health
      • Patient harmed
      • Obstetrics and gynaecology/ Maternity
      • Medical device
      • Epilepsy
      • Pregnancy

    By Patient Safety Learning, 24 February, 2021

    • 0 comments
    • 352 views
    • 
    • Added by Patient Safety Learning
    • 24 February, 2021

20. Infected Blood Inquiry: The Haemophilia Society under pressure (21 February 2021)

    • Blood / blood products
    • Medicine - Haematology
    • (and 3 more)

      Tagged with:

      • Blood / blood products
      • Medicine - Haematology
      • Patient safety incident
      • Investigation
      • Communication problems

    By Patient Safety Learning, 22 February, 2021

    • 0 comments
    • 253 views
    • 
    • Added by Patient Safety Learning
    • 22 February, 2021

21. Independent Maternity Services Oversight Panel: Thematic Maternal Category Report (January 2021)

    • Maternity
    • Baby
    • (and 5 more)

      Tagged with:

      • Maternity
      • Baby
      • Patient death
      • Patient harmed
      • Recommendations
      • Investigation
      • ICU/ ITU/ HDU

    By Patient Safety Learning, 6 February, 2021

    • 0 comments
    • 98 views
    • 
    • Added by Patient Safety Learning
    • 6 February, 2021

22. The Haemophilia Society: The Infected Blood Inquiry

    • Blood / blood products
    • Medicine - Haematology
    • (and 3 more)

      Tagged with:

      • Blood / blood products
      • Medicine - Haematology
      • Investigation
      • Patient safety incident
      • Communication problems

    By Patient Safety Learning, 22 January, 2021

    • 0 comments
    • 217 views
    • 
    • Added by Patient Safety Learning
    • 22 January, 2021

23. House of Commons Debate - Ockenden Review

    • Patient harmed
    • Investigation
    • (and 2 more)

      Tagged with:

      • Patient harmed
      • Investigation
      • Maternity
      • Patient safety incident

    By Mark Hughes, 11 December, 2020

    • 0 comments
    • 469 views
    • 
    • Added by Mark Hughes
    • 11 December, 2020

24. Senedd Cymru - Welsh Parliament: Ministerial response to a written question on the Cumberlege Review (26 November 2020)

    • Medical device
    • Medication
    • (and 5 more)

      Tagged with:

      • Medical device
      • Medication
      • Maternity
      • Recommendations
      • Pregnancy
      • Patient harmed
      • Womens health

    By Mark Hughes, 2 December, 2020

    • 0 comments
    • 576 views
    • 
    • Added by Mark Hughes
    • 2 December, 2020

25. The life and death of Elizabeth Dixon: a catalyst for change (26 November 2020)

    • Investigation
    • Special needs
    • (and 9 more)

      Tagged with:

      • Investigation
      • Special needs
      • Patient death
      • Recommendations
      • Baby
      • Care plan
      • Clinical process
      • Complaint
      • Clinical governance
      • Transparency
      • Organisational culture

    By Patient Safety Learning, 26 November, 2020

    • 0 comments
    • 2,188 views
    • 
    • Added by Patient Safety Learning
    • 26 November, 2020