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Patients: Safety

Volume 479: debated on Monday 1 September 2008

To ask the Secretary of State for Health how many patient safety incidents of each type in each strategic health authority area have been reported to the National Reporting and Learning System since it was established. (221026)

The following tables show patient safety incidents of each type in each strategic health authority (SHA) area that have been reported to the National Reporting and Learning System since it was established in 2003.

Incidents reported to the NRLS (1 Nov 2003 - 30Jun 2008) by SHA, broken down by incident type

Incident Category

N/A

North East

North West

Yorkshire and the Humber

East Midlands

West Midlands

Access, admission, transfer, discharge (including missing patient)

12,023

29,916

24,272

16,506

11,408

Clinical assessment (including diagnosis, scans, tests, assessments)

4,995

19,250

12,532

8,731

5,648

Consent, communication, confidentiality

3,577

17,954

9,310

8,087

6,048

Disruptive, aggressive behaviour

11,237

15,085

17,202

11,393

6,784

Documentation (including records, identification)

5,056

18,159

15,270

10,023

12,562

Infection Control Incident

2,364

5,289

2,943

3,566

3,080

Implementation of care and ongoing monitoring / review

3,291

7,993

6,044

5,100

4,179

Infrastructure (including staffing, facilities, environment)

3,496

21,887

18,267

10,080

7,570

Medical device/equipment

1

2,910

12,600

8,348

6,178

5,860

Medication

9,804

29,306

26,172

16,325

13,683

Patient abuse (by staff/third party)

1,477

2,536

1,259

1,783

1,924

Patient accident

55,132

135,863

119,306

64,714

65,329

Self-harming behaviour

7,242

13,245

9,952

9,795

6,350

Treatment, procedure

9,930

33,162

23,783

14,191

15,954

Not stated

18

75

45

33

32

Other

5,594

10,376

7,329

4,360

5,739

Total

1

138,146

372,696

302,034

190,865

172,150

Incident Category

East of England

London

South East Coast

South Central

South West

Total

Access, admission, transfer, discharge (including missing patient)

17,746

30,465

11,682

13,190

15,631

182,839

Clinical assessment (including diagnosis, scans, tests, assessments)

9,200

27,631

5,435

5,405

13,087

111,914

Consent, communication, confidentiality

7,013

15,671

6,760

5,845

11,344

91,611

Disruptive, aggressive behaviour

10,507

18,066

7,268

3,811

5,872

107,225

Documentation (including records, identification)

12,378

24,233

7,227

5,518

12,161

122,587

Infection Control Incident

3,169

6,070

1,857

2,458

3,533

34,329

Implementation of care and ongoing monitoring / review

8,652

9,623

3,666

3,138

8,148

59,834

Infrastructure (including staffing, facilities, environment)

18,746

25,355

12,034

11,349

23,187

151,971

Medical device/equipment

6,554

16,755

4,971

4,948

8,481

77,606

Medication

23,240

37,161

12,574

13,884

20,883

203,032

Patient abuse (by staff/third party)

2,244

2,259

493

983

845

15,803

Patient accident

92,257

105,427

59,534

57,727

97,146

852,435

Self-harming behaviour

6,366

11,844

3,589

3,378

4,551

76,312

Treatment, procedure

24,329

38,758

16,295

16,451

25,432

218,285

Not stated

42

123

37

22

57

484

Other

9,447

12,903

3,578

2,713

5,277

67,316

Total

251,890

382,344

157,000

150,822

255,635

2,373,583

1 Incident could not be assigned to a SHA.

Incidents reported to the NRLS (1 November 2003 to 30 June 2008) by SHA

Reporting SHA

Number of incidents reported

Percentage

North West

372,696

16

London

382,344

16

Yorkshire and the Humber

302,034

13

East of England

251,890

11

South West

255,635

11

East Midlands

190,865

8

West Midlands

172,150

7

South East Coast

157,000

7

North East

138,146

6

South Central

150,822

6

Could not be assigned to a SHA

1

0

Total

2,373,583

100

Notes:

1. These incidents exclude duplicated incidents and incidents where the submitting organisation/individual did not consent to provide their details. Incidents where the data provided did not meet our minimum requirements were excluded from these results. Incidents from Welsh organisations, community pharmacies and NHS Direct were also not included.

2. As reporting to the NRLS is done on a voluntary basis, the figures provided should not be used as an indicator of national trends.

3. NRLS Reports Disclaimer Statement: NPSA Staff

The incidents summarised in this report have been drawn from the NPSA National Reporting and Learning System (NRLS). The NRLS supports the goal of the NPSA to make patient care safer. The NRLS is a confidential reporting system. The incidents are reported through a variety of routes, by individual NHS staff, including through local trust risk management systems and web based e-forms (including an open access e-form). The individual reports are not investigated or verified by the NPSA. Since these incidents are self-reported they are not necessarily representative of the NHS across England and Wales and therefore need interpreting with care.

4. Permission must be obtained from the NPSA before the information contained within the report it is published or passed on to a third party outside the NPSA.

For help with interpretation please contact the statistics team on statisticsteam@npsa.nhs.uk.