Headlines: December 16th, 2002

A discussion document published today looks at ways in which doctors, managers, the government and patients can understand and reduce clinical risks in health care and improve the safety of patients.The BMA paper, ‘Patient Safety and Clinical Risk’, puts forward a new model for addressing risk. It accepts that risk can never be completely eradicated but says the health service will be under increasing pressure to ensure that avoidable problems are minimised.

Dr Vivienne Nathanson, the BMA’s Head of Science and Ethics said, “It is important to move away from a blame culture where one person takes the blame for mistakes, towards a system where the whole team, doctors, nurses, patients, managers and policy-makers, share the burden of responsibility when things go wrong.”

She said the BMA was not suggesting that doctors who made mistakes should be let off but it was necessary to look at why mistakes happened so lessons could be learned from them and clinical risk to patients could be reduced.

The discussion paper suggests that errors in the health system can be divided into five areas – individual clinical incompetence or malpractice, systems failure, risks resulting from cost constraints, patients’ perception of risk and risks inherent in clinical procedures.

The document says that if risk is analysed in those categories patients, healthcare professionals, managers and governments might be able to define the most effective way of managing risk generally and in relation to individual cases as well as identifying where the responsibility for different levels of risk should lie. The paper concludes that while doctors have to be accountable for their own errors they should not be held responsible for risks over which they have little or no influence.