Trusts ignoring safety alerts should be named, says CMO

BMJ 2005; 331 doi: (Published 21 July 2005) Cite this as: BMJ 2005;331:176
  1. Adrian O'Dowd
  1. London

    The chief medical officer, Liam Donaldson, has called for details to be made public of NHS organisations that fail to comply with alerts concerning patients' safety.

    Launching his annual report last week, he said the NHS was failing in this area of health and specifically called on the Healthcare Commission to pay special attention to compliance with safety alerts. He also called for a national group to be established to review the effect of safety alerts and to identify factors that impede compliance.

    “I have examined experience in implementing four national safety alerts. The uptake by local NHS services was, in places, slow and inconsistent. The NHS needs to strengthen its performance in this area,” he said.

    He also drew attention to the congenital anomaly gastroschisis, the number cases of which, he said, is rising with no good reason.

    “The number of cases of gastroschisis has almost trebled in the last 10 years—particularly in babies born to young mothers,” said Professor Donaldson. “I want to see more research into the underlying causes and investigation into the reasons behind the recent increase in numbers of cases.”

    The report also recommends better funding of regional registers of congenital anomalies, which would cost an estimated £1.5m ($2.6m; €2.2m) a year for the whole of England. Professor Donaldson said he had heard of people who were trying to run such registers being hampered by going “hand to mouth” for continued funding.

    The chief medical officer also wanted to see tighter controls on tobacco smuggling and cheap tobacco. It is estimated that UK taxes and duties had been avoided on 25% of all cigarettes and 75% of all hand rolling tobacco consumed in England, so that the price of an illicit pack of cigarettes was £2.50 rather than the legal price of £4.89.

    “Smuggled and cheap tobacco undermines health and health inequality goals by making tobacco widely available at much cheaper prices,” he said, and he called for closer cooperation between the United Kingdom and other European Union countries in dealing with the problem.

    The present “ridiculous” cross border limit of 3200 cigarettes or 3 kg of hand rolling tobacco should be reduced to 200 cigarettes or 250 g of hand rolling tobacco, he said.


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