At present, all deaths in hospitals are usually only examined by the doctor(s) who were looking after the patient. They certify the death and determine the cause to be listed on the death certificate.
From 2018, however, the health secretary Jeremy Hunt has announced reforms to the way hospital deaths are examined.
Hospital Death Examination Reforms
At a speech this week at the global summit on patient safety, Mr Hunt said all deaths which occur in hospital will be examined by a second doctor unconnected to the patient’s treatment.
The change is intended to provide a ‘second look’ at the events before the patient died, which will include the treatment the patient received.
The rationale behind the change is about improving the care patients receive while in hospital and creating greater transparency.
The Royal College of Physicians says that a second examination of all hospital deaths will “provide patients and their families with the openness and transparency which they deserve when things go wrong, and to support healthcare professionals to learn from and correct any deficiencies in care which are found. We will only improve if we move from a culture of blame to a culture of learning.”
It is important to highlight that the change is not about carrying out a detailed investigation into every hospital death.
Mr Hunt stated:
“There won’t be a detailed investigation of every death as most deaths are predictable and from a medical point of view fairly straightforward, though sad for those affected.”
The expert medical examiner can, however, “go into real detail about cases they have real worry about and report that to the Trust”.
Also, important to note is that there are plans for a change in the law. Doctors and nurses will be given legal protection to allow them to speak openly about mistakes in the treatment or care given to patients.
The legal protection in intended to create ‘safe spaces’ for health care professionals to raise concerns. This is vital as without this, second examinations may become meaningless.
The second examination of all hospital deaths was first recommended in the 2005 Harold Shipman inquiry. Although long overdue, this is a welcomed move given that 1 in 20 hospital deaths are reported as being preventable (owing to incorrect diagnosis and/or treatment).
One study found 1 in 10 patients are affected by potentially serious medical errors, with half of these patients dying as a result.
What impact the second examinations will have remains to be seen. It is certainly hoped that they will result in better patient care and greater transparency in which hospital failings are more readily and easily identified.
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