NHS England have a list of ‘never events’. This is a list to help providers ensure they give patients ‘safe, high quality, compassionate care within local health systems that are financially sustainable’.
The ‘never events’ are basically circumstances that should never happen to a patient. The list includes situations such as amputating the wrong leg, using the wrong implant or prosthesis, or leaving a foreign object in a patient.
Imagine the shock, presumably to both the patient and the hospital, when it was identified that a patient had been given invasive gynaecological procedure, instead of the fertility treatment she’d attended for. It wasn’t the wrong surgery in the wrong location – it was in the incorrect patient. Both patients were in outpatients clinic, one for her first fertility appointment, and the other for a colposcopy (to look at the cervix). It transpires both patients had similar sounding names.
There were 472 serious healthcare incidents reported in England between 2019 and 2020. The Healthcare Safety Investigation Branch says such cases are able to lead to physical and emotional harm – and changes are needed to improve safety controls, staff workloads and time pressures.
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