To do no harm, first count the harm

This weekend I stumbled across Medical Harm – I believe I have @amcunningham to thank for bringing it to my attention.

In a nutshell the blog is run by Dr Phil Hammond and Andrew Bousfield. It is a blog site that allows readers to submit information and documents to them, safely, which they may in turn put in the public domain. The site contains a bank of inspirational stories and experiences and it aims to build networks of people who wish to raise concerns about medical harm and work together to identify ways to reduce it.

So what is medical harm and why should we be worried about it? 

Medicine is unique amongst legalised industries in that it causes significant harm as well as enormous benefit. We think that in order to do no harm, first you have to count the harm. Patients, relatives and staff should be united in speaking up when shit happens or,  better still, just before so we can stop shit from happening.

Healthcare harms patients and staff in all sorts of ways. Missing or delaying a diagnosis, giving the wrong or suboptimal treatment or even giving the right treatment badly causes harm every day….There’s a difficult balance between an open culture that allows staff to admit to errors and near misses safe in the knowledge that they won’t be punished, and a ‘no blame’ culture where noone is ever held to account for serious failure because it’s always the system’s fault.

By calling this site Medical Harm, we want the NHS, public, press and politicians to acknowledge that healthcare is very dangerous and harm is surprisingly common. Then we need everyone – patients, relatives and staff – to be encouraged to step in to stop it, or failing that report it so we have continuous ‘harm alarms’ – like smoke alarms – on every ward and in every GP surgery.

So why am I interested?

Well, I consider myself to be a realist. I understand that when you’re dealing with people who are ill, mistakes will happen. When you are working under stress and pressure, mistakes will happen. When you work in an environment where there is no support when mistakes happen, more mistakes will happen. I also have spent *a lot* of time in hospitals and critiquing the NHS systems over the past four years – my Dad has a terminal diagnosis of cholangiocarcinoma (bile duct cancer), my mum had a TIA a couple years ago, and my grandparents have both had medical concerns of late, with my 92 year old grandfather being admitted to hospital twice in the last two years.

I’ve seen the absolute best of the NHS, I’ve seen fantastic individuals going the extra mile, working in spite of broken systems. I have no doubt that I have seen a few near misses, Dad has been discharged with the wrong medication, has been given incorrect treatment (poor communication), he has jumped out of bed with a newly fitted stent to get a nurse’s attention when no-one was available to respond to the alarm and the old guy opposite was fitting, and my absolute most irritating situation the Junior Doctor who patronised the hell out of me, told me to give Dad some TLC and tried to discharge Dad with a box of antibiotics for Swine Flu – until we demanded a second opinion and he was admitted with MRSA septicemia that required two weeks of intravenous antiobiotics and a three week hospital stay (little bit angry about that one still).

That said, if it wasn’t for the risks taken by his consultant and medical team Dad would have died years ago. That’s the harsh reality of my experience of medicine – it doesn’t always come down to science, more often than not it comes down to balancing possibilities of risk and taking chances. As a family member of someone who has already outlived his diagnosis, who has received life saving treatment, I wouldn’t want to complain….but I do want to highlight dangerous practice.

I hope that Medical Harm will help more people to share their experience, and identify what can be improved. I’ve always felt that Dad is lucky as he has a number of us loudly and (most of the time) articulately advocating on his behalf, not everyone is in that position.

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