The products of the database envisaged by the NHS adverse event pilot
study research team (BMJ 2001,322:517-519) would be very welcome. It would
be useful to couple the database with a convincing explanation for the
extent of adverse events and for why more resources have not been spent in
attempts to reduce either their extent or their adverse consequences,
despite the evident public concern.
Indeed, why has there apparently not yet been a systematic database that
encompasses adverse events across the NHS?
It might be that more of the scarce resources available to the NHS
would be directed to these purposes, by those in a position to do so, if
they could capture more of the benefits or savings from doing so or if
they themselves were to experience more adverse consequences associated
with the events in question. If so, attention to the relevant incentive
structures might prove to be part of a cost effective and appropriate
response to the issue.
In any case, the application of some additional insight into what
limits the commitment of scarce resources in such a way would complement
the prospective evidence base. Together, they might help in the
development of a workable strategy for improving the consistent quality of
service in the NHS for patients which their advocates seem to want. A
greater confidence in our ability to select a cost effective and
appropriate response, based on sound explanation as well as sound
information, might even increase the preparedness to bear the cost of a
better database more quickly.
Rapid Response:
Explaining the Evidence on Adverse Events
The products of the database envisaged by the NHS adverse event pilot
study research team (BMJ 2001,322:517-519) would be very welcome. It would
be useful to couple the database with a convincing explanation for the
extent of adverse events and for why more resources have not been spent in
attempts to reduce either their extent or their adverse consequences,
despite the evident public concern.
Indeed, why has there apparently not yet been a systematic database that
encompasses adverse events across the NHS?
It might be that more of the scarce resources available to the NHS
would be directed to these purposes, by those in a position to do so, if
they could capture more of the benefits or savings from doing so or if
they themselves were to experience more adverse consequences associated
with the events in question. If so, attention to the relevant incentive
structures might prove to be part of a cost effective and appropriate
response to the issue.
In any case, the application of some additional insight into what
limits the commitment of scarce resources in such a way would complement
the prospective evidence base. Together, they might help in the
development of a workable strategy for improving the consistent quality of
service in the NHS for patients which their advocates seem to want. A
greater confidence in our ability to select a cost effective and
appropriate response, based on sound explanation as well as sound
information, might even increase the preparedness to bear the cost of a
better database more quickly.
Competing interests: No competing interests