THE BLOG

Why the Onus Is on Us to Prevent Patient Harm

14/08/2013 15:35 BST | Updated 14/10/2013 10:12 BST

Claims this week of a 'toxic cocktail' poisoning the NHS might be accurate enough, but they do little to aid in the campaign for real change to standards of care in UK hospitals.

A term coined by health ombudsman Dame Julie Mellor, this particular cocktail describes the, at times, lethal combination of problems that foster negligence within the NHS. According to Mellor, patients are either too scared to complain in the first place, or their concerns are buried by a service-wide culture that refuses to accept its own mistakes.

Between the tabloids and the daunting responsibility of running our nation's hospitals, let's assume the NHS is aware of its own various failings. It might even be taking meaningful action to improve, though what that means in real terms remains to be seen. The concern, then, is that patients are absenting themselves from the process of reporting and preventing negligent care.

Too frightened to speak out. For those of us who feel duty-bound to report back to the bemused barista when our coffee is not quite hot enough, or to shout that no, we cannot hear you at the back of the room, these words will serve only to perplex. How could someone risk another person's safety for the sake of, what, saving face?

Of course, it's a little more involved than that, and an alarmingly common scenario too. Nothing feels right when you're watching someone struggle from their hospital bed to eat, to sleep or even to speak. Accepting things like pain or a loved one's conviction that a treatment is or isn't working is challenging, yet necessary.

So is it all that surprising for people to make exceptions in such circumstances? There are two familiar stories - the person who refuses to let suspicions of medical negligence lie, and the other person, similarly well-intentioned, who sets aside their own doubts and feelings in the face of seemingly better advice. It could - and does - go either way for each.

For one of our clients, Jean Cadden, fear of further harm was a sufficient deterrent against pursuing a formal complaint. With a history of mental illness, her husband was admitted to hospital after threatening self-harm. He died in hospital of what was later proved medical negligence. During his admission Jean questioned if her husband's needs were being met, but verbal complaints fell on deaf ears and matters simply worsened.

On one occasion, Jean waited several hours on a hospital ward to see her husband, staff threatening to call the police if she did not leave. The police were not involved, and when she was eventually granted a brief visit she found her husband emaciated and begging for water. Jean declined to complain further after this experience, fearing she might be denied visitation.

An overwhelming majority of cases could be avoided by early intervention. Educating people about their right to complain - and the need to do so - is key. Mellor points to a culture of defensiveness in the NHS, whereby complaints are met with disavow. Knowing how to complain effectively then, and taking simple steps to do so, could do much to help the service as well as to save the human cost.

Challenging a situation is inherently problematic, more so if you are not the individual directly affected. What gives you, the loved one, the bystander, right to complain about another person's body, their health and welfare? Your relationship, in fact, gives you plenty of practical authority to speak up when something seems amiss. And share your concerns with other people - safety in numbers is real.

Collect information. Write things down. Ask questions and keep informed. Documenting events is the best way to make sure you aren't dissuaded from pursuing a complaint. It's the NHS, so remember that once you've said something, it may not immediately change. You'll need to check and keep checking that measures are being taken to remedy poor care.

There are instances of medical negligence never witnessed by the patient involved, never suspected by a loved one, and never even considered by the practitioner responsible until it is too late to intervene. But for those we can act upon, let's.