Culture change is not the only way to address mistakes in the NHS

Nurses want to be open about mistakes, but are sometimes afraid to be, as Jeremy Hunt rightly says. What is needed is a change in the prevailing organisational culture – and a commitment to having enough staff in post

Confessing to an error at work can be difficult for fear of the consequences, especially if these might include being struck off your professional register.

So it is hardly surprising that some nurses can be reluctant to own up after realising that they have administered the wrong drug or an incorrect dosage. However, even health and social care secretary Jeremy Hunt acknowledges that this culture has to change.

Figures released through a study commissioned by the government reveal that there are an estimated 237 million medication errors in England every year.

Mistakes range from giving patients the wrong medication to delivering prescriptions late, and the impact is serious: around 1,700 deaths are caused directly, and up to 22,000 deaths may be related.

Leadership welcome

Practical steps are planned to make errors less likely, in part through the introduction of electronic prescribing systems. But as Mr Hunt has acknowledged, a culture change is arguably even more important.

Speaking at a patient safety event in London, he said health professionals want to be open and transparent about their mistakes, but the prevailing organisational culture can make that practically impossible.

He is dead right, and his leadership on this issue is welcome. Of course, he could also help by ensuring the NHS has enough permanent staff in post, as this is a key factor too.

There are fewer mistakes when patients are cared for by staff who know a ward’s patients, equipment and procedures.

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