Feature Medical Error

Why sorry doesn’t need to be the hardest word

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3258 (Published 01 June 2011) Cite this as: BMJ 2011;342:d3258
  1. Jane Feinmann, freelance journalist
  1. 1London, UK
  1. jane{at}janefeinmann.com

The question of open disclosure in medical errors has crept up the political agenda in the UK and doctors should brace themselves for a culture change in this area. Jane Feinmann reports

“It was a classic case of multiple observer error and one that we didn’t believe could happen in our unit,” recalls Iain Johnstone, consultant paediatric intensivist at Newcastle upon Tyne Hospitals NHS Foundation Trust. He was describing his feelings after the discovery of a clinical error by a junior doctor and planning the next stage of management of the patient.

The question of what doctors should do in Dr Johnstone’s position has been on the political agenda for years—at least since it was memorably summed up by former chief medical officer Liam Donaldson in 2004. “To err is human, to cover up is unforgivable and to fail to learn is inexcusable,” he told the Alliance for Patient Safety’s conference in Washington.

Yet despite repeated attempts by the UK National Patient Safety Agency to bring about a “being open” framework, enabling clinicians to communicate patient safety incidents with patients and their relatives, there is evidence that this still does not happen routinely.

Around half a million NHS patients experience avoidable harm every year. Yet statistics show that only a quarter of NHS trusts routinely provide information to patients about such incidents, with 6% admitting to never providing this information.1 A recent Medical Protection Society survey found that a third of its members did not believe doctors would be willing to be open with patients about mistakes they had made.2

Now the UK government is planning further action. Its programme for government, published jointly by David Cameron and Nick Clegg in May 2010,3 included “a commitment to require hospitals to be open about mistakes and always tell …

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