Victim Of A Never Event?
Never events' can be defined as “very serious, largely preventable patient safety incidents that should not occur if the relevant preventative measures have been put in place”, which, put simply, means an event that should never happen in a healthcare environment if basic good practice is followed.
The concept of a never event was first proposed by former health minister Lord Darzi, who wanted to promote transparency in the health service and create a system of accountability with regards to serious patient safety incidents. Subsequently, a policy was drawn up by the National Patient Safety Agency (NPSA), which was introduced to the NHS in April 2009.
The policy consists of 8 core never events, which are:-
- Wrong site surgery;
- Retained instrument or surgical swab post-operation;
- Wrong route administration of chemotherapy;
- Misplaced naso or orogastric tube not detected prior to use;
- Inpatient suicide using non-collapsible rails;
- Escape from within the secure perimeter of medium or high secure mental health services by patients who are transferred prisoners;
- In-hospital maternal death from post-partum haemorrhage after elective caesarean section;
- Intravenous administration of mis-selected concentrated potassium chloride.
Local commissioners and healthcare providers are also allowed to negotiate and set their own locally agreed never events, which must sit alongside the current national list of never events.
The NPSA is now consulting with the government on a broader list of never events to be published in April 2011. There are a number of proposals which may be added, including death or serious injury as a result of insulin overdose, failure to prescribe or administer insulin when clinically indicated, and death or serious injury resulting from falls from unrestricted windows. The medical charity Action against Medical Accidents is also calling for the inclusion of pressure sores.
What To Do If A Never Event Happens To You?
During its first phase of its implementation (April 2009 to March 2010) it was not compulsory for never events to be reported. Even so, the NPSA learned of 111 never events, fifty-seven of which were related to wrong-site surgery, and forty-two of which reported misplaced naso or orogastric tubes.
However, in March 2010 the NPSA published a report updating the framework of never events. Amongst other things, it is now necessary for NHS Trusts to report the occurrence of a never event to the NPSA, who will then give the relevant information to the Quality Care Commission.
Furthermore, Primary Care Trusts must now recover the costs of any procedure or treatment where a never event has happened. This applies to seven of the eight national core never events, excluding escape from within the secure perimeter of medium or high secure mental health services by patients who are transferred prisoners.
To prove that a never event took place, the incident must fulfil the following criteria:-
- The incident has clear potential for or has caused severe harm/death;
- There is evidence of occurrence in the past (i.e. it is a known source of risk);
- There is existing national guidance and/or national safety recommendations on how the event can be prevented and support for implementation;
- The event is largely preventable if the guidance is implemented;
- Occurrence can be easily defined, identified and continually measured.
In addition to the recovery of costs you are entitled to, you may wish to claim medical negligence compensation through the courts, or pursue a complaint using the NHS Complaints Procedure.
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