Public inquiries, patient safety and the implementation gap (Helen Hughes, 31 March 2023)

Summary

In this article, published in the Future Healthcare Journal, Helen Hughes, Chief Executive of Patient Safety Learning, reflects on how avoidable harm continues to occur, ten years on from the Francis report into major patient safety failings at Mid Staffordshire NHS Foundation Trust. She describes an implementation gap—where safety concerns and issues highlighted in inquiries and reviews are not being translated into improvements in patient safety. The article outlines some of the key barriers to implementation and suggests what needs to change to ensure we truly learn lessons from patient safety scandals such as Mid Staffordshire.

Content

Related reading

Patient Safety Learning - Mind the implementation gap: The persistence of avoidable harm in the NHS (7 April 2022)

Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (February 2013)