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228161

	registered interest
	date	18/03/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, with reference to his Department's recent report, Culture change in the NHS, Cm 9009, whether he plans to place responsibility for patient safety alerts within (a) NHS England or (b) an arms-length organisation.
	tabling member constituency	Denton and Reddish
	tabling member printed	Andrew Gwynne
	uin	228119
	answer	answer is ministerial correction date of answer 23/03/2015 answer text <p>Healthcare providers are expected to implement all the actions contained in a patient safety alert that are relevant to them and ensure that all relevant parts of their organisation and staff are aware of the information and/or the required changes. Providers should be scrutinising the implementation of their alerts and satisfying themselves that the alerts are complete by the designated deadline.</p><p> </p><p> </p><p> </p><p>NHS England publishes monthly data about any trusts who have failed to declare compliance with stage one, two, or three of the National Patient Safety Alerting System’s (NaPSAS) alerts by their set due date. Provider compliance should also be an integral part of the commissioners’ responsibilities for improving quality.</p><p> </p><p> </p><p> </p><p>As part of its inspections, the Care Quality Commission (CQC) looks at how providers respond to patient safety alerts as evidence of how effectively they manage and address safety concerns, and how they use this as learning to improve their safety systems and processes. CQC is continuing to develop and embed its approach to the use of data and intelligence across all the sectors it regulates as an integral part of its new approach to inspections, and has given greater prominence to safety alerts in its revised surveillance model. CQC’s Intelligent Monitoring system for the Acute Sector includes a composite indicator around completion of safety alerts and CQC is currently considering whether this can be implemented for the other sectors it regulates. This contributes to providers’ overall risk scores, which inform both the scheduling and prioritisation of inspections and the identification of focus areas for inspections.</p><p> </p><p> </p><p> </p><p>Monitor is responsible for ensuring NHS foundation trusts are well-led so that they can provide quality care on a sustainable basis and would expect to be alerted by their providers of anything that might have a bearing on compliance with their licence including where there are significant issues regarding compliance with patient safety alerts. The NHS Trust Development Authority (TDA), as part of its oversight and escalation process, uses quality surveillance monitoring which it reviews on a monthly basis and which it uses to hold trusts to account for the timely compliance with alerts. This is undertaken via the TDA’s regular integrated delivery meetings with the trusts.</p><p> </p><p> </p><p> </p><p>The Government has agreed to consider with relevant organisations the options for transferring NHS England’s responsibilities for safety to a single national body and this will include responsibility for patent safety alerts. No decision has yet been taken about the specific functions to be transferred and until such time, NHS England will continue to be responsible for these functions.</p><p> </p><p> </p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter grouped question UIN 228067 228068 question first answered 23/03/2015 17:55:34 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	1506 label Biography information for Andrew Gwynne

228187

	registered interest
	date	18/03/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, how many NHS trusts and foundation trusts have had action taken against them for not implementing guidance from patient safety alerts since May 2010; and what action was taken in each such case.
	tabling member constituency	Denton and Reddish
	tabling member printed	Andrew Gwynne
	uin	228067
	answer	answer is ministerial correction date of answer 23/03/2015 answer text <p>Healthcare providers are expected to implement all the actions contained in a patient safety alert that are relevant to them and ensure that all relevant parts of their organisation and staff are aware of the information and/or the required changes. Providers should be scrutinising the implementation of their alerts and satisfying themselves that the alerts are complete by the designated deadline.</p><p> </p><p> </p><p> </p><p>NHS England publishes monthly data about any trusts who have failed to declare compliance with stage one, two, or three of the National Patient Safety Alerting System’s (NaPSAS) alerts by their set due date. Provider compliance should also be an integral part of the commissioners’ responsibilities for improving quality.</p><p> </p><p> </p><p> </p><p>As part of its inspections, the Care Quality Commission (CQC) looks at how providers respond to patient safety alerts as evidence of how effectively they manage and address safety concerns, and how they use this as learning to improve their safety systems and processes. CQC is continuing to develop and embed its approach to the use of data and intelligence across all the sectors it regulates as an integral part of its new approach to inspections, and has given greater prominence to safety alerts in its revised surveillance model. CQC’s Intelligent Monitoring system for the Acute Sector includes a composite indicator around completion of safety alerts and CQC is currently considering whether this can be implemented for the other sectors it regulates. This contributes to providers’ overall risk scores, which inform both the scheduling and prioritisation of inspections and the identification of focus areas for inspections.</p><p> </p><p> </p><p> </p><p>Monitor is responsible for ensuring NHS foundation trusts are well-led so that they can provide quality care on a sustainable basis and would expect to be alerted by their providers of anything that might have a bearing on compliance with their licence including where there are significant issues regarding compliance with patient safety alerts. The NHS Trust Development Authority (TDA), as part of its oversight and escalation process, uses quality surveillance monitoring which it reviews on a monthly basis and which it uses to hold trusts to account for the timely compliance with alerts. This is undertaken via the TDA’s regular integrated delivery meetings with the trusts.</p><p> </p><p> </p><p> </p><p>The Government has agreed to consider with relevant organisations the options for transferring NHS England’s responsibilities for safety to a single national body and this will include responsibility for patent safety alerts. No decision has yet been taken about the specific functions to be transferred and until such time, NHS England will continue to be responsible for these functions.</p><p> </p><p> </p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter grouped question UIN 228068 228119 question first answered 23/03/2015 17:55:34 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	1506 label Biography information for Andrew Gwynne

228188

	registered interest
	date	18/03/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what plans (a) his Department, (b) NHS England and (c) the Care Quality Commission have to ensure that patient safety alert guidance is implemented; and how his Department plans to monitor compliance with that guidance.
	tabling member constituency	Denton and Reddish
	tabling member printed	Andrew Gwynne
	uin	228068
	answer	answer is ministerial correction date of answer 23/03/2015 answer text <p>Healthcare providers are expected to implement all the actions contained in a patient safety alert that are relevant to them and ensure that all relevant parts of their organisation and staff are aware of the information and/or the required changes. Providers should be scrutinising the implementation of their alerts and satisfying themselves that the alerts are complete by the designated deadline.</p><p> </p><p> </p><p> </p><p>NHS England publishes monthly data about any trusts who have failed to declare compliance with stage one, two, or three of the National Patient Safety Alerting System’s (NaPSAS) alerts by their set due date. Provider compliance should also be an integral part of the commissioners’ responsibilities for improving quality.</p><p> </p><p> </p><p> </p><p>As part of its inspections, the Care Quality Commission (CQC) looks at how providers respond to patient safety alerts as evidence of how effectively they manage and address safety concerns, and how they use this as learning to improve their safety systems and processes. CQC is continuing to develop and embed its approach to the use of data and intelligence across all the sectors it regulates as an integral part of its new approach to inspections, and has given greater prominence to safety alerts in its revised surveillance model. CQC’s Intelligent Monitoring system for the Acute Sector includes a composite indicator around completion of safety alerts and CQC is currently considering whether this can be implemented for the other sectors it regulates. This contributes to providers’ overall risk scores, which inform both the scheduling and prioritisation of inspections and the identification of focus areas for inspections.</p><p> </p><p> </p><p> </p><p>Monitor is responsible for ensuring NHS foundation trusts are well-led so that they can provide quality care on a sustainable basis and would expect to be alerted by their providers of anything that might have a bearing on compliance with their licence including where there are significant issues regarding compliance with patient safety alerts. The NHS Trust Development Authority (TDA), as part of its oversight and escalation process, uses quality surveillance monitoring which it reviews on a monthly basis and which it uses to hold trusts to account for the timely compliance with alerts. This is undertaken via the TDA’s regular integrated delivery meetings with the trusts.</p><p> </p><p> </p><p> </p><p>The Government has agreed to consider with relevant organisations the options for transferring NHS England’s responsibilities for safety to a single national body and this will include responsibility for patent safety alerts. No decision has yet been taken about the specific functions to be transferred and until such time, NHS England will continue to be responsible for these functions.</p><p> </p><p> </p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter grouped question UIN 228067 228119 question first answered 23/03/2015 17:55:34 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	1506 label Biography information for Andrew Gwynne

926528

	registered interest
	date	18/06/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of introducing into NHS England a scheme analogous to the Scottish National Patient Safety Programme.
	tabling member constituency	South West Bedfordshire
	tabling member printed	Andrew Selous
	uin	154631
	answer	answer is ministerial correction date of answer 21/06/2018 answer text <p>We note the Scottish National Patient Safety Programme aims to improve the safety and reliability of health and social care, and reduce harm.</p><p> </p><p>Like Scotland, our aim is to improve patient safety and for the National Health Service to be one of the safest healthcare systems in the world.</p><p> </p><p>Following the tragic events at Mid Staffordshire NHS Foundation Trust, the Government has introduced a number of significant programmes to promote and encourage better regulation, greater transparency and candour, and a culture of learning in the NHS in England, drawing from other safety critical industries.</p><p> </p><p>To further drive a culture of learning, the NHS trusts are required to review and investigate deaths of their patients and publish the learning and steps they are taking to improve patient safety. An independent Healthcare Safety Investigation Branch (HSIB) was set up in April 2016 and is now conducting major safety investigations into the most serious risks for patients, with a specific focus on system-wide learning and improvement. The HSIB’s remit was extended in April 2018 to include the investigations of early neonatal deaths, term stillbirths and cases of severe brain injury in babies as well as all cases of maternal death. Work is underway to further improve medicines safety including the accelerated rollout of electronic prescribing in hospitals, monitoring higher risk prescribing practice linked to hospital admissions, and addressing so called ‘human factors’ that contribute to errors.</p><p> </p><p>In June 2018, the Government announced a further package of measures to improve patient safety including a new National Clinical Improvement Programme that will provide NHS consultants with confidential data on their clinical results and help improve patient outcomes, the introduction of a system of medical examiners and the intention to extend the Learning from Deaths programme to general practice and ambulance trusts to promote learning and enable health organisations and healthcare professionals to learn from one another.</p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 21/06/2018 16:56:59 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	1453 label Biography information for Andrew Selous

984845

	registered interest
	date	10/10/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, how many patient safety incidents were recorded as absconder or missing patient by hospitals in England and Wales in the National Reporting and Learning System in each care setting in the latest period for which information is available.
	tabling member constituency	Stockport
	tabling member printed	Ann Coffey
	uin	177600
	answer	answer is ministerial correction date of answer 17/10/2018 answer text <p>During the period 1 October 2017 to 31 March 2018 National Reporting and Learning System (NRLS) recorded 12,398 cases of “missing or absconded patient” across England and Wales. This category on the NRLS includes patients who left without signing a ‘discharge against medical advice’ form and those who failed to return from agreed leave on time, rather than solely reports of patients who absconded or were reported missing.</p><p> </p><p>A breakdown by care settings for both England and Wales is provided in the following table.</p><p> </p><p>Incidents reported as “Missing or absconded patient”, by care setting for England and Wales</p><table><tbody><tr><td><p>Care Setting</p></td><td><p>England</p></td><td><p>Wales</p></td><td><p>Total</p></td></tr><tr><td><p>Acute / general hospital</p></td><td><p>5,781</p></td><td><p>146</p></td><td><p>5,927</p></td></tr><tr><td><p>Ambulance service</p></td><td><p>15</p></td><td><p>0</p></td><td><p>15</p></td></tr><tr><td><p>Community and general dental service</p></td><td><p>1</p></td><td><p>0</p></td><td><p>1</p></td></tr><tr><td><p>Community Nursing, medical and therapy service (incl. community hospital)</p></td><td><p>312</p></td><td><p>57</p></td><td><p>369</p></td></tr><tr><td><p>Community optometry / optician services</p></td><td><p>0</p></td><td><p>0</p></td><td><p>0</p></td></tr><tr><td><p>Community pharmacy</p></td><td><p>0</p></td><td><p>0</p></td><td><p>0</p></td></tr><tr><td><p>General practice</p></td><td><p>4</p></td><td><p>0</p></td><td><p>4</p></td></tr><tr><td><p>Learning disabilities service</p></td><td><p>87</p></td><td><p>2</p></td><td><p>89</p></td></tr><tr><td><p>Mental health service</p></td><td><p>5,754</p></td><td><p>239</p></td><td><p>5,993</p></td></tr><tr><td><p>Total</p></td><td><p>11,954</p></td><td><p>444</p></td><td><p>12,398</p></td></tr></tbody></table><p><strong> </strong></p> answering member constituency Gosport answering member printed Caroline Dinenage question first answered 17/10/2018 13:48:41 answering member 4008 label Biography information for Dame Caroline Dinenage
	tabling member	458 label Biography information for Ann Coffey

178543

	registered interest
	date	09/02/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, with reference to Patient Safety Alert: Improving medication error incident reporting and learning, published by NHS England on 20 March 2014, what progress he has made in developing the National Medication Safety Network; and what channels are available for patient groups to make representations to the National Medication Safety Network.
	tabling member constituency	Newcastle upon Tyne North
	tabling member printed	Catherine McKinnell
	uin	223771
	answer	answer is ministerial correction date of answer 24/02/2015 answer text <p>NHS England, in collaboration with the Medicines and Healthcare products Regulatory Agency (MHRA), has carried out the following activities in relation to developing the National Medication Safety Network:</p><p> </p><p> </p><p> </p><p>- Undertaken nine web events with presentations and recordings posted to the <a href="http://www.patientsafetyfirst.nhs.uk/" target="_blank">www.patientsafetyfirst.nhs.uk</a> web forum accessed by Medication Safety Officers (MSOs). A total of 699 MSOs have participated in these formal web meetings.</p><p> </p><p>- Run a conference for MSOs on 19 January 2015 with keynote speakers from NHS England, MHRA and the National Reporting and Learning System with 150 MSOs in attendance.</p><p> </p><p>- Run dedicated web events for the 18 Community Pharmacy MSOs.</p><p> </p><p>- Are arranging one-day regional meetings on 10 March 2015 (London), 15 July 2015 (Midlands) 12 May (South), 14 October (North) inviting 70-100 MSOs. A key aim of these events is to provide the opportunity for MSOs to feedback in person to NHS England and the MHRA on development of the MSO role.</p><p> </p><p>- We have dedicated (0.4 full-time equivalent) support for development of the MSO role from the Specialist Pharmacy Service. The remit includes monitoring of engagement by MSOs in the network.</p><p> </p><p> </p><p> </p><p>Although the NHS England Medication Safety team have not yet received any formal representations from national patient groups, MSOs have been encouraged to liaise with their local organisation ‘patient and public voice’ leads to help recruit patients onto their medication safety committees.</p><p> </p><p> </p><p> </p><p>Members of the public and patient groups can also make enquiries directly to NHS England.</p><p> </p> answering member constituency Central Suffolk and North Ipswich answering member printed Dr Daniel Poulter question first answered 24/02/2015 14:08:53 answering member 3932 label Biography information for Dr Dan Poulter
	tabling member	4125 label Biography information for Catherine McKinnell

1468132

	registered interest
	date	07/06/2022
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment he has made of the impact of (a) staffing levels and (b) response times on patient safety in the most recent period for which data is available.
	tabling member constituency	Kingston upon Hull North
	tabling member printed	Dame Diana Johnson
	uin	13658
	answer	answer is ministerial correction date of answer 20/06/2022 answer text <p>No specific assessment has been made. Data on patient safety incidents is collected and reported through the National Reporting and Learning System (NRLS). However, the NRLS is a largely voluntary scheme for reporting patient safety incidents and does not provide the actual number of patient safety incidents occurring in the National Health Service.</p> answering member constituency Lewes answering member printed Maria Caulfield question first answered 20/06/2022 14:21:47 answering member 4492 label Biography information for Maria Caulfield
	tabling member	1533 label Biography information for Dame Diana Johnson

749475

	registered interest
	date	06/07/2017
	answering body	Leader of the House
	answering dept id	34
	answering dept short name	Leader of the House
	answering dept sort name	Leader of the House
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Leader of the House, when and in which House the Government plans to introduce the Patient Safety Bill.
	tabling member constituency	Kingston upon Hull North
	tabling member printed	Diana Johnson
	uin	3492
	answer	answer is ministerial correction date of answer 11/07/2017 answer text <p>The Government has set out an ambitious programme of 27 bills and drafts bills and noted that additional bills will be announced as the session progresses. The timescales for forthcoming bills and draft bills will be announced in the usual manner in due course.</p><p> </p> answering member constituency South Northamptonshire answering member printed Andrea Leadsom question first answered 11/07/2017 16:11:25 answering member 4117 label Biography information for Andrea Leadsom
	tabling member	1533 label Biography information for Dame Diana Johnson

229164

	registered interest
	date	23/03/2015
	answering body	Department of Health
	answering dept id	17
	answering dept short name	Health
	answering dept sort name	Health
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health, what assessment he has made of the effect of the abolition of the Patient Safety Agency and the transfer of its responsibility for the National Reporting and Learning System to NHS England on the number of patient safety alerts issued between June 2012 and December 2013.
	tabling member constituency	Oldham East and Saddleworth
	tabling member printed	Debbie Abrahams
	uin	228685
	answer	answer is ministerial correction date of answer 26/03/2015 answer text <p>Responsibility for issuing patient safety advice to the healthcare system in the form of patient safety alerts transferred from the National Patient Safety Agency to NHS England in June 2012. Between June 2012 – December 2013 one Patient Safety Alert (NHS/PSA/W/2013/001: ‘Placement devices for nasogastric tube insertion DO NOT replace initial position checks’) was issued on 5 December 2013. To date, all providers have reported this alert as either ‘complete’ or ‘action not required’.</p><p> </p><p> </p><p> </p><p>During the period in question NHS England maintained a constant review of patient safety incidents reported to the National Reporting and Learning System involving death and severe harm and, had an urgent patient safety issue needing alerting been identified, an alert would have been issued.</p><p> </p><p> </p><p> </p> answering member constituency Mid Norfolk answering member printed George Freeman question first answered 26/03/2015 14:20:27 answering member 4020 label Biography information for George Freeman
	tabling member	4212 label Biography information for Debbie Abrahams

1568112

	registered interest
	date	18/01/2023
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Patients: Safety
	house id	1
	legislature	25259 pref label House of Commons
	question text	To ask the Secretary of State for Health and Social Care, what assessment the Department has made of the number of patients who are avoidably harmed during routine medical procedures and surgeries.
	tabling member constituency	Hendon
	tabling member printed	Dr Matthew Offord
	uin	126603
	answer	answer is ministerial correction date of answer 24/01/2023 answer text <p>The National Reporting and Learning System (NRLS) provides a national database of reported patient safety incidents for the National Health Service in England. This data is published as official statistics alongside commentary. Within NRLS data, it is not possible to determine easily if the reported incidents took place during medical procedures and surgery that can be considered ‘routine’. The most recent publication for 2021/22 was published in October 2022 and available at the following link:</p><p><a href="https://www.england.nhs.uk/patient-safety/national-patient-safety-incident-reports/national-patient-safety-incident-reports-13-october-2022/" target="_blank">https://www.england.nhs.uk/patient-safety/national-patient-safety-incident-reports/national-patient-safety-incident-reports-13-october-2022/</a></p><p>The total number of patient safety incidents reported was 2,345,815. Most incidents are reported as causing no harm, 70.6% or low harm, 26.0%. Fewer than 4% of incidents reported caused higher degrees of harm, of which 0.5% were categorised as severe harm or death. NHS England reviews information in these two categories to characterise new, emerging and under-recognised risks and determine how they might be addressed.</p><p>The Learn from Patient Safety Events service will this year fully replace the NRLS. It will change the way information is collected to make it easier for providers to record and learn from patient safety incidents.</p><p>The Government continues to pursue higher patient safety standards and a transparent, learning culture in order to support the NHS to achieve continuous improvement in safety and to reduce harmful events happening in the first place.</p> answering member constituency Lewes answering member printed Maria Caulfield question first answered 24/01/2023 14:34:19 answering member 4492 label Biography information for Maria Caulfield
	tabling member	4006 label Biography information for Dr Matthew Offord