Health worker safety: a priority for patient safety

17 September 2020 marks the first anniversary of World Patient Safety Day, and the launch by the World Health Organisation (WHO) of a global campaign aimed at raising global awareness about patient safety concerns.

The campaign “Speak up for patient safety” emphasised the importance of governments and policy makers prioritising patient safety and encouraged healthcare professionals to create an honest and transparent patient safety culture; promote blame free reporting and learning from mistakes.

At the time that the campaign launched, NHS England and NHS Improvement had just published the patient safety strategy “Safer Culture, Safer Systems, Safer Patients”, which formed part of a long term plan to improve patient safety in the NHS. The strategy found that 11,000 patients die in England and Wales every year because of patient safety failures at a cost of at least £1 billion to the NHS each year.

Although patient safety campaigners welcomed the strategy, in particular the commitment to learn from errors made, many were concerned that it was simply a Public Relations exercise that did not go far enough to properly address the issue of patient safety. Many were concerned that the strategy failed to properly address the underlying issues within the NHS, which lead to such patient safety incidents, such as a lack of funding; a failure to engage with all stakeholders in a proper and honest debate about failings; and the lack of consistency and cohesion between the many different NHS Trusts, which means that systemic issues are not properly identified and addressed.

One year on from the first World Patient Safety Day, the focus has rightfully shifted – in what is an unprecedented year – to health worker safety, highlighting the fact that safer health workers are much more likely to result in safer patients.

Protecting health workers from COVID-19

There have been many worrying headlines regarding failings in provisions for the protection of health workers in the UK during the COVID-19 pandemic, from the lack of personal protective equipment (PPE) to large discrepancies across the country as to how many health workers are being tested for the virus. But what are the truths behind the headlines?

A report from June this year by the National Audit Office has revealed that the stockpile of PPE that Public Health England had prior to the arrival of the virus was appropriate only for a pandemic flu outbreak: this therefore did not contain gowns or visors, only aprons and clinical waste bags, which are not enough to protect health workers in the event of a virus such as COVID-19.

Before this PPE had always been manufactured and supplied on a ‘just in time’ basis, but as of 1 April 2020 the Department of Health had created a dedicated central supply route to meet the greater volume requirements. NHS trusts were also able to purchase their own PPE locally where it was available. However, social care providers were left very much underserved by central stocks, and from 6 April to 19 May more than 80% of local resilience forums reported that PPE was having a high or significant disruptive impact in their area across health and social care services.

Availability of testing for health workers has also been a hot topic in recent months. While the same report from the NAO acknowledges that the number of NHS staff and their households tested each day grew from 1,500 to 11,500 over the course of April, 29% of doctors who had needed a test in the week preceding 14 May reported that testing had been neither accessible, timely nor convenient. As the NAO report says, ‘when health and social care staff cannot get prompt tests, this can have several adverse consequences, including potentially unnecessary absence from work, personal anxiety and increased spread of the virus’.

While things are improving, it is important that efforts are sustained to get health workers the protections and support they need at work. It is clear that in order to keep patients safe, it is crucial that we keep health workers shielded, healthy and mentally well so that they are able to do all they can for anyone requiring medical attention during this period.

‘Help us help you’

The NHS itself has recognised the importance of keeping staff healthy during the pandemic so other vital services are not adversely affected. The ‘Help us help you’ initiative, which was rolled out in April, is designed to encourage those who require urgent care and/or treatment unrelated to the virus to continue to utilise their local healthcare services. Facilities are in place to ensure that COVID and non-COVID services are separated, so that the public need have no fear of seeking treatment if they need it.

Part of this has involved ensuring the availability of 33,000 extra beds in the NHS, as well as an increase in the number of online consultations, so that effective social distancing can be maintained in all circumstances, and make both patient and health worker safety much more likely.

The initiative is vitally important to let the public know that they should not be ignoring symptoms because they are afraid of coming into contact with the virus. In April the British Heart Foundation reported a 50% drop in the number of people attending hospital with heart attacks compared to 2019, and Cancer Research UK has reported that the number of urgent referrals has dropped to around 25% of usual levels. Cancer Research UK in particular are acutely aware that cancer services such as screening (a crucial tool in early diagnosis) and chemotherapy have been disrupted, as capacity is overwhelmed and certain facilities are deemed unsafe for immunocompromised patients; all the more reason, they urge, for those who notice symptoms to arrange to speak to their GP as soon as possible so that the doctors can try to find the most expedient solution to the issue.

While non-COVID services have naturally been affected by the pandemic, the NHS is doing everything it can to minimise its impact, and the message is from its Chief Executive is clear: ‘ignoring problems can have serious consequences - now or in the future’.

Speak up for health worker safety!

This is the official call to action for World Patient Safety Day, and it has never been more relevant than it is right now. Health worker safety is absolutely crucial to us all navigating this pandemic as smoothly as we can, as it will enable all of our vital services, both COVID- and non-COVID-related, to continue with as little disruption as possible.

While the situation for both patients and health workers is improving overall, we must ensure standards do not slip in terms of providing protection for either.