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Westminster Heath Forum-improving patient safety in the NHS: culture change, regulation and implementing the national patient safety strategy

We are delighted to have been invited to deliver a keynote speech for a third time at the Westminster Health Forum. Dr Samantha Batt-Rawden DAUK Chair will be be delivering a keynote speech on the Learn Not Blame movement and joining a panel on patient safety and regulation.

This seminar will be a timely opportunity to discuss the priorities for improving patient safety in the NHS - looking at:

  • implementing the national NHS Patient Safety Strategy,

  • moving forward with a culture change, and

  • next steps for policy.


There will be keynote contributions addresses from: Rt Hon Jeremy Hunt MP, former Secretary of State for Health; Dr Nigel Acheson, Deputy Chief Inspector of Hospitals, CQC; Denise Chaffer, Director of Safety and Learning, NHS Resolution; Sir Robert Francis QC, President, The Patients Association; Dr Leslie Hamilton, Chair, Independent Review of Gross Negligence Manslaughter and Culpable HomicideDr Bill Kirkup, Chair, Independent Investigation, Failings at Liverpool Community HealthFiona MacNeill, Clinical Lead, Breast Surgery, GIRFT and Erik Mayer, Consultant Urological Surgeon, Imperial College Healthcare NHS Trust.

The agenda

  • Implementation and the new national patient safety strategy;

  • Improving patient safety in the NHS and tackling the barriers to delivering safe care;

  • Patient, family and public engagement;

  • Education, training and professional regulation - promoting a fair and just culture in the workplace;

  • Regulation, reducing avoidable harm and progress since Opening the door to change;

  • The impact of investigations in the NHS - whistleblowing, transparency and moving forward with a culture change;

  • Learning from harm and reducing the cost of litigation in the NHS; and

    eventing safety failures, the role of technology and the impact of leadership.

Case study:

  • The role of GIRFT in eliminating unwarranted variation in patient safety - with Fiona MacNeill, Clinical Lead, Breast Surgery, GIRFT.

Strategy delivery and key aims

Following the recent announcement of a new NHS Patient Safety Strategy, delegates will assess key issues for delivery moving forward.

We expect discussion on:

  • engaging with patients and families,

  • the role of technology in improving patient safety, and

  • fostering a culture of transparency and accountability - including the roles and challenges for leadership, and for the health and care workforce.

Regulation, training, culture change and trust

The agenda looks at the effectiveness of regulation in improving safety.

It follows the CQC’s annual report and Opening the door to change report, which concluded that the education and training of healthcare staff needed improvement in order to reduce Never Events - and that a culture change and collaborative approach was required to make this happen.

The conference will also be an opportunity to assess the key issues for professional regulation and the next steps to achieve a learning and not a blaming culture in the NHS.

It takes place in light of the Independent review of gross negligence manslaughter and culpable homicide, and the recommendations that the GMC must repair their relationship with doctors to regain trust.

Investigations and whistleblowing

Attendees will discuss the impact of investigations in changing cultures of safety in the NHS and the role of whistleblowing in improving the safety of healthcare systems and processes - following the announcement of the investigation into Failings at Liverpool Community Health, which aims to identify opportunities for learning.

We also expect findings from investigations conducted by the Healthcare Safety Investigation Branch to be assessed - such as the recommendations to NHS England and NHS Improvement to expand the remit of the Cross-System Sepsis Board in the Investigation into recognising and responding to critically unwell patients.

Reducing avoidable harm

Further sessions examine what more could be done to reduce avoidable harm, learn from harm when failures occur and address the rising cost of clinical negligence in the NHS - including the progress of programmes such as GIRFT in reducing unwarranted variation in patient safety.