Primary care drives up error reporting rates

Experts say the increase reflects an improved reporting culture, not a rise in mistakes.

A 25 per cent rise in medical errors reported in primary care reflects a more rigorous approach by practices and other providers, NHS leaders say.

The rise in incidents reported by primary care organisations (PCOs) in England and Wales to the National Patient Safety Agency (NPSA) outstripped the NHS-wide rise of 7 per cent.

In the six months from October 2008 to March 2009 almost 50,000 reported errors occurred in a primary care setting and 203 primary care patients died.

More than 1 per cent of the mistakes in primary care resulted in a patient's death or severe harm and 7 per cent caused moderate harm.

In 92 per cent of cases, however, the patient was unharmed or only slightly harmed.

NPSA chief executive Martin Fletcher said that the increase in reports was a good thing: 'These data are sound evidence of an improving reporting culture across the NHS. Front-line staff are more likely than ever to raise safety concerns much more openly.'

Care Quality Commission chief executive Cynthia Bower said the watchdog would check up on trusts with low reporting rates.

Low-reporting PCOs include Brighton and Hove City PCT, Enfield PCT, North Tyneside PCT and the former Ceredigion and Vale of Glamorgan local health boards.

South Tyneside PCT reported higher error rates than any other PCO. PCOs with inpatient provision, such as South Tyneside, generally had higher error rates.

North East Essex PCT had the highest reporting rate for a PCO without inpatient facilities.

GPC deputy chairman Dr Richard Vautrey said: 'Primary care is getting better at reporting incidents. It is not actually getting worse.

'Practices are being actively encouraged to report, which is a good thing. This may be a sign that PCOs are making it easier to report. If the exercise is a learning experience rather than a blame culture, that will encourage practices to report.'

Error reporting
Leading sources of primary care errors
  • Patient accidents: 31.3%
  • Medication errors: 13.2%
  • Access, admission, transfer, discharge: 12.4%
  • Implementation of care and ongoing monitoring/review: 7.7%

Source: NPSA

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