Intended for healthcare professionals

Rapid response to:


“Weak” safety culture behind errors, says chief medical officer

BMJ 2003; 326 doi: (Published 08 February 2003) Cite this as: BMJ 2003;326:300

Rapid Response:

Boards and Department only have self to blame for continuing weak safety culture

The message is not getting across to those at the frontline about
developing a safety culture and that should perhaps not be a surprise. To
borrow and rewrite a paragraph from the conclusion on page 23 of the
Healthcare Commission's December 2004 report on the clinical and corporate
governance failings in the Mid Yorkshire Hospitals NHS Trust it is
possible to understand why.

"It is essential that trust boards and the Department of Health
respond effectively when clinicians raise concerns about the performance
of a managerial colleague. Their concerns should be taken seriously,
treated fairly, investigated fully and any necessary remedial action
taken. Learning from Bristol: The report of the public inquiry into
children's heart surgery at the Bristol Royal Infirmary 1984 - 1995 and a
considerable body of research highlight the need for healthcare
professionals - and that term does not exclude healthcare managers who are
also valued professionals in the NHS - to be alert to shortcomings in
their own performance and that of colleagues, and be willing to report

Unfortunately, reporting "them" sometimes falls on deaf ears and does
not make any difference with the sort of consequences outlined by the
Healthcare Commission's Mid Yorkshire investigation.The safety culture
will not change unless those who preach in organisations also practice as
was made clear by Dame Janet Smith in her Fifth Shipman Inquiry report.

(The views expressd are my own and not those of my employing

Competing interests:
Interest in patient safety and manager regulation. Consultant at Pinderfields Hospital, Wakefield 1993 - 2000.

Competing interests: No competing interests

13 April 2005
Nigel Dudley
Consultant in Elderly Medicine
St James's University Hospital, LEEDS. LS9 7TF