Patient safety would be undermined if manslaughter review hampers reflective practice, NHS chief executive says

BMJ 2018; 360 doi: (Published 07 March 2018) Cite this as: BMJ 2018;360:k1077
  1. Tom Moberly
  1. The BMJ

Improvements to patient safety in the NHS would be undermined if doctors reflected less on their practice in the wake of the Hadiza Bawa-Garba case, the chief executive of NHS England has said.

Simon Stevens said that it would be a “retrograde” step if reflective practice was “diminished” as a result of the review that is underway in the wake of the case.

In February, England’s health secretary, Jeremy Hunt, announced a review of the application of gross negligence manslaughter in the NHS.1 The review was launched in response to a High Court ruling to strike Bawa-Garba, a trainee paediatrician, from the UK medical register.

Stevens spoke about the issue at the Nuffield Trust summit on 2 March. He was responding to a question about the Bawa-Garba case from Jane Dacre, president of the Royal College of Physicians.

Bawa-Garba was convicted of manslaughter in 2015,2 and February’s High Court verdict came after the General Medical Council appealed against a medical practitioners tribunal decision to suspend her for 12 months rather than erase her.3

“Trainees now feel ‘there but by the grace of God go I’,” Dacre said. “We’re in a position where, if we’re not careful, the people who are being regulated run the risk of falling out of love with their own regulator, which is a very uncomfortable position to be in. How can you help us to sort it out?”

In response, Stevens said that there was a review underway of “not only the legal aspects of that case but also the NHS or healthcare consequences.”

“It would be very retrograde if it were to mean that a safe space for reflective practice was in some way diminished and a lot of the gains that have been made in the patient safety agenda were undermined,” he said.

“That review is going to have to answer some questions about the way manslaughter law works and the way the GMC then judge on the back of it. This is not a completely straightforward situation. The exchange of correspondence in The BMJ—a powerful intervention by Nick Ross and a thoughtful response by Terence Stevenson—lays out the contours of the debate,” he said.45


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