Empirical description of safety case development at service level in healthcare.
Safety cases can support adoption of proactive and rigorous safety management.
Adaptation to purpose and use of safety cases might be required in healthcare.
Education should be provided to practitioners and regulators.
The report also confirms that the NHS serves as a ‘safety net’ for the private sector with around 6,000 people a year transferred to NHS hospitals following treatment in private hospitals.
Read the press release and coverage on BBC News, the Telegraph and Health Service Journal
Read a blog on patient safety from Peter Walsh
Sources of further information on patient safety private hospitals
Read a blog from Colin Leys exploring the issues in the report.
To help frame their conversation, they use the paper How Does Audit and Feedback Influence Intentions of Health Professionals to Improve Practice?
Our feelings about audits
Feedback from the audit process
The format of a cluster-randomised trial
Lab vs. field results
How to act on audit results
Analysing the study’s results
This resource, developed by UK healthcare professionals and policymakers, provides the information to support a safe and effective prescribing decision.
1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain.
2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation).
3. The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is no increased benefit: tapering or stopping high dose opioids needs careful planning and collaboration.
4. If a patient has pain that remains severe despite opioid treatment it means they are not working and should be stopped, even if no other treatment is available.
5. Chronic pain is very complex and if patients have refractory and disabling symptoms, particularly if they are on high opioid doses, a very detailed assessment of the many emotional influences on their pain experience is essential.