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Feature Patient Safety

Safety first

BMJ 2009; 338 doi: (Published 06 February 2009) Cite this as: BMJ 2009;338:b420
  1. Jane Feinmann, freelance journalist
  1. 1London
  1. jane{at}

    Hundreds of patients are harmed unnecessarily while receiving NHS care. Jane Feinmann reports on a campaign that hopes to make this much rarer

    The recent alert from the National Patient Safety Agency to implement the World Health Organization’s safer surgery checklist1 is just one element in a far more ambitious campaign to reduce the incidence of avoidable harm and death in the NHS. More than 80% of acute trusts—and a growing number of primary care and mental health trusts—have already signed up to the Patient Safety First campaign since its launch last July. The goal is to “change the culture of the NHS to one that makes the safety of patients the highest priority and makes all avoidable death and harm unacceptable.”

    The campaign contains five interventions to reduce avoidable harm (box). But although the WHO checklist is set to become mandatory for theatre staff by February 2010, participation in the rest of the campaign is voluntary. In the place of regulation, the campaign, sponsored by National Patient Safety Agency, the Health Foundation, and the NHS Institute for Innovation and Improvement, builds on the passion of its leaders and their experience of this transformational approach.

    Campaign’s five interventions (

    • Leadership for safety—A prerequisite for all trusts signing up to the campaign. It aims to ensure a leadership culture at Board level that promotes quality and patient safety and provides an environment where continuous improvement in harm reduction becomes routine throughout the organisation

    • Reducing harm from deterioration—Reducing in-hospital cardiac arrest and mortality through earlier recognition and treatment of deteriorating patients

    • Reducing harm in critical care—Through reliable application of central line and ventilator care procedures

    • Reducing harm in perioperative care—Includes prevention of surgical site infection and use of WHO’s safe surgery checklist

    • Reducing harm from high risk medicines—Includes anticoagulants, injectable …

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