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When will the NHS learn from mistakes?

Most of my clients tell me the motivation for bringing a claim in medical negligence is the hope that in doing so lessons will be learned to avoid the same mistake causing significant harm to anyone else. Sadly I see the same or similar mistakes happening again and again and my experience is borne out by a report published yesterday by NHS Resolution who handle claims on behalf of NHS Trusts.

The report concluded poor quality reporting has hampered efforts to reduce medical negligence leading to cerebral palsy or brain injuries. They found evidence of poor quality serious incident investigations at a local level after negligence in maternity care. The patient and family were involved in only 40% of investigations, and an external reviewer was brought in to analyse mistakes in just 4% of cases.

‘The quality of serious incident investigations has repeatedly been found to be poor with very little or no training for investigators across the NHS,’ said the report. It recommends that a working party should discuss creating a national standardised and accredited training programme for all staff conducting serious incident investigations.

Helen Vernon, chief executive of NHS Resolution, added: ‘Negligent care resulting in cerebral palsy has a devastating and lifelong effect on the child, their family and carers. Whilst thankfully, these cases are very rare, they can be prevented. What we have learned from these events and the steps that we and our partners have committed to as a result, represents a vital step towards preventing future harm.’

Let us take it from here.

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