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It investigates patient safety concerns across the NHS in England and in independent healthcare settings where safety learning could also help to improve NHS care. [1] It aims to produce rigorous, non-punitive, and systematic patient safety investigations and to develop system-wide safety recommendations for learning and improvement.
A significant event audit (SEA), also known as significant event analysis, is a method of formally assessing significant events, particularly in primary care in the UK, with a view to improving patient care and services.
The Act obligates frontline personnel to report adverse events to a national reporting system. Hospital owners are obligated to act on the reports and the National Board of Health is obligated to communicate the learning nationally. The reporting system is intended purely for learning and frontline personnel cannot experience sanctions for ...
During 2006-2007 about 30 million working days were lost due to work-related ill health, and 6 million due to workplace injury. In the same period, there were 141,350 incidents reported although it has been estimated that some 274,000 ought to have been reported. Further, 241 people were killed at work during this time.
The NHS Litigation Authority was established in 1995 as a special health authority. [2] Its current duties are established under the National Health Service Act 2006. [3] It began using the name NHS Resolution in April 2017, reflecting a change of role to "the early settlement of cases, learning from what goes wrong and the prevention of errors" according to Jeremy Hunt, Secretary of State for ...
An incident is an event that could lead to the loss of, or disruption to, an organization's operations, services or functions. [2] Incident management (IcM) is a term describing the activities of an organization to identify, analyze, and correct hazards to prevent a future re-occurrence.
A serious case review (SCR) in England is held after a child or vulnerable adult dies or is seriously injured under circumstances where abuse or neglect are thought to have been involved. [1] Its purpose is to learn lessons to help prevent future similar incidents.
NHS England produced a report on 148 reported never events in the period from April to September 2013 highlighting particular hospitals with more than one such event. [6] In 2021 there were still about 500 never events each year in the English NHS. According to Jeremy Hunt a hospital can get as many as 108 safety related instructions in a year. [7]