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Reaction to Jeremy Hunt’s patient safety initiatives: “how will legal safe places work?”

The MDU’s head of professional standards and liaison, Dr Michael Devlin

Initiatives to improve patient safety are likely to be welcomed by doctors who already have clear ethical guidance from the GMC to cooperate with and contribute to such enquiries. We look forward to receiving further detail about how the HSIB will operate and in particular how it intends to share examples of good investigatory practice throughout the NHS.

Although it has been announced that legal ‘safe spaces’ will protect and support healthcare staff raising concerns and contributing to investigations, it is also clear that there is nothing to stop other bodies, for example an NHS trust disciplinary panel or the GMC, from collecting the same information independently and disciplining doctors and other healthcare staff.

Therefore, it remains to be seen whether the new measures intended to provide immunity to staff will in practice foster the culture of openness that will allow patient safety initiatives to flourish.

We have also been told today that medical examiners will independently review and confirm the cause of all deaths from April 2018. There is no detail about who the medical examiners will be, how they will be trained and funded and what their independent review process will consist of.

Until such further detail is available it isn’t possible to determine the future contribution medical examiners could make to patient safety.

But we also need to be clear about what patient safety initiatives can deliver. There is little evidence that patient safety initiatives alone lead to lower rates of litigation which is why the MDU is campaigning for legal reforms to tackle the unsustainable spiralling cost of claims in England and Wales.

Dr Richard Stacey, Senior Medicolegal Adviser at Medical Protection

We strongly support the principle of legal protection for healthcare professionals who provide information following a mistake.

We have long called for an open, transparent learning culture in place of the blame and shame that currently exists in the NHS. Sometimes things go wrong and this legal ‘safe space’ could go some way to reduce the climate of fear amongst healthcare professionals, and create an environment where they are supported in admitting errors and learning from mistakes. We know that when organisations embrace open disclosure it benefits all parties, resulting in safer doctors and greater levels of patient satisfaction.

We believe this principle should also be considered across healthcare – particularly in general practice – however, we await more detail to see how this could work in practice.

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