Good afternoon and welcome to my latest patient safety update in which we look at a raft of government announcements including their elective recovery plan, integration white paper, and ‘war on cancer’. We also highlight some recent research on medication error, an HSIB report on the same issue, and our usual look at where we are on Covid.

ELECTIVE RECOVERY PLAN After a false start on Monday the elective recovery plan was eventually published yesterday. The top line ambitions are for nearly 20,000 two year waits to be gone by July of this year, waits of over 18 months gone by April 2023, waits of more than 65 weeks by March 2024 and waits of more than a year to be eliminated by March 2025. The overall aim is not just to get back to pre-pandemic levels of activity but to deliver 30% more activity by 2024/25 than before the pandemic. There has been some complaining that we’re not getting more for the £12bn a year of additional funding we’re putting in, including some interesting suggestions that the Treasury wanted the one year deadline to be met in 2024. On the other hand tying results so closely to eliminating long waiters will worry others because it may mean people with the most need not being prioritised as Nick Robinson pointedly asked Sajid on the Today programme on Monday.

WHERE’S THE WORKFORCE? The NHS Confederation has broadly welcomed the timings, as has NHS Providers, but both argued that these ambitions will be difficult to meet without a fully costed, long-term workforce strategy. Regular readers will know this is something I’ve been pushing for a while now without, so far, much success. It’s not that the plan doesn’t include a workforce section - it states the NHS will recruit more than 10,000 nurses from overseas this financial year (although this is still within the 50,000 more nurses overall target) and 5,000 healthcare support workers – it’s just that his is nowhere near enough to actually tackle the problem at least according to the Health Foundation. This is something I’m sure the Lords will return to when they next consider the Health and Care Bill.

WAR DECLARED on cancer anyway…by the Health Secretary as he published a call for evidence to inform a new 10 year cancer plan. I really welcome the ambition in this area, namely to match the best European cancer survival rates. Sajid particularly wants views on increasing early diagnosis, boosting the cancer workforce (yup) and tackling disparities in outcomes. This is very timely as the Select Committee will be publishing its report on cancer services shortly - but the proof of the pudding will be whether as much effort goes into expanding treatment capacity as into diagnostic capacity. Otherwise what are we going to do about all those extra cancers we detect?

INTEGRATION Another White Paper for everyone to get their teeth into, this time on how to better integrate health and social care services. This contains some good stuff on giving patients more choice and delivering greater personalised care, sharing data more widely between the services, and intervening earlier. I am slightly questioning what’s new here, though, as much of this stuff has been talked about for a long time and is already starting to be put in place in the better ICS areas. The key will be whether the government succeeds in turbo-charging electronic health records and the pooling of budgets between the two systems. 

MEDICATION ERROR RESEARCH During a meeting with the WHO last week Sir Liam Donaldson highlighted this fascinating research that found that “medication harm indeed accounts for half of the overall preventable harm in medical care”. With some estimates stating that this type of error costs $42 billion annually it is good news this will be the new  WHO patient safety focus starting with this year’s World Patient Safety Day in September.

HSIB ON PRESCRIBING ERRORS On the same topic HSIB has published a report recommending that the regulation of electronic prescribing systems software “could help to reduce the chance of harmful weight-based prescribing errors”. They found that 13% of prescriptions written for children contained errors so there is clearly a lot to do in this specific area. And with 237 million medication errors in England over a year costing nearly £100m there are good safety and financial reasons for the NHS to embrace these recommendations and indeed do more on the issue.

COVID The ONS hasn’t updated its number as yet but recent estimates still suggest that 1 in 20 people in the community in England having the virus in the week ending 29th January (roughly the same as the previous week). The Covid Dashboard records a further 20% drop in cases, 10% drop in hospital admissions, but an 11% uptick in deaths.  Crucially the number of patients in hospital has been steadily declining since the end of January so hopefully pressure on the NHS will start to ease. 

THE ADMIN As ever you can sign up to receive this update via our website here and please tell any friends you think might enjoy it. Patient safety is fun…well fascinating anyway! 

Jeremy Hunt