Maintaining safety of staff and patients

It has been a busy period for healthcare regulation. David Hare, head of the Independent Healthcare Providers Network (IHPN), gives a heads-up on just some of the recent developments that independent practitioners need to know about.

58,000 staff reported unwarranted sexual approaches from patients or other members of the public last year, which equates to one in 12 NHS workers

Ensuring the safety and dignity of healthcare staff should be the top priority of all healthcare providers, and NHS England’s recently published letter outlining the findings from the NHS Staff Survey regarding sexual safety was sobering reading. 

Overall, 58,000 staff reported unwarranted sexual approaches from patients or other members of the public last year, which equates to one in every 12 NHS workers. 

These findings highlight the prevalence of the problem and re-affirmed the importance of empowering healthcare colleagues who have experienced or witnessed these crimes to speak up, report and call out this behaviour – wherever they work in the health system. 

While over half of IHPN members have signed up to the NHS’s Sexual Safety in Healthcare Charter, which is designed to tackle this abuse, we want to see all independent providers becoming signatories.

We strongly encourage those who have not signed up to do so as soon as possible.

This is a real priority for IHPN and we are also making an effort to support our members and those working in the sector on this, including with a campaign group.

The group is called Surviving in Scrubs and was set up by two doctors to raise awareness of and put an end to sexism, sexual harassment and sexual assault in healthcare – to ensure our members are best placed to tackle this issue.

Do we really aid those who speak up?

As Independent Practitioner Today readers will, of course, be aware, healthcare providers and professionals have a fundamental responsibility to be open and honest with patients under their care, particularly in the rare cases when things go wrong. 

There has long been a professional ‘duty of candour’ which is regulated by the GMC and other professional regulators and which applies to individual practitioners. 

However, since 2015, all health and social care providers have a statutory obligation around ‘duty of candour’. 

They must be open and honest with patients and their families when something goes wrong that appears to have caused, or could lead to, moderate harm or worse in the future – known as a ‘notifiable safety incident’. 

This was introduced in light of the Mid Staffs scandal where it became clear that a lack of an open and transparent culture and an ability for staff to be candid around when things go wrong was a key contributor to patient harm. 

Assessing providers

Since then, the Care Quality Commission has been assessing providers’ commitment to duty of candour as part of its inspection regime.

But the Department of Health and Social Care (DHSC) is now undertaking a review to understand to what extent the duty of candour is honoured, monitored and enforced by providers. 

This includes how well staff understand the duty and whether providers have adequate systems and senior level accountability for monitoring the duty which can support organisational learning. 

Here at the Independent Health­care Providers Network (IHPN) we welcome this review; it is something we have long been calling for. 

In particular, there are currently two parts to the duty of candour regulations – one for NHS providers and one for all other organisations – something we feel is not in line with a ‘whole systems’ approach to safety and quality.

Likewise, many new patient safety initiatives have been put in place since duty of candour was introduced  in 2015 – most recently ‘Learning from Patient Safety Events’ – and ensuring all these programmes align and help rather than hinder providers fostering open, transparent cultures will be key.

Getting ready for medical examiners

The Department of Health and Social Care (DHSC) also recently announced the first major reforms to the death certification system in England and Wales in over 50 years. (See ‘Death is going through change’) 

While a medical examiner system has been implemented across the countries since 2019, the Government has confirmed that this system will now be put on a statutory footing. 

This means that all deaths in any health setting, including the independent sector, that are not investigated by a coroner will be reviewed by a medical examiner.

And all healthcare providers will be required to share records of deceased patients with medical examiner offices. 

This is something IHPN has been working with NHS England for some time on, and will provide real benefits in ensuring both NHS and independent providers can better support bereaved people and drive further improvements in patient safety.

IHPN has been working closely with the National Medical Exam­iner, Dr Alan Fletcher, to ensure the sector and those working in it are well prepared for the changes.

We are pleased many of our members are already making early connections with medical examiner offices to help staff understand the new regulations.

David Hare (right) is chief executive of the Independent Healthcare Providers Network (IHPN)