Final Report > Chapter 26: The Safety of Care > Incorporating a concern for safety into systems and policies

Incorporating a concern for safety into systems and policies

49 We argued at the outset of this chapter that a concern for the safety of patients must be visible at every level of the NHS. But it must be more than a concern. The systems and policies of the NHS and of individual trusts must incorporate that concern, reflect it and thereby promote the safety of patients. Commitment to safety is not a separate, autonomous, `self-contained' policy. It must be embedded in everything which the NHS does, from, for example, the education and training of healthcare professionals, to the design of buildings and equipment, to protocols for treatment, care and the administration of drugs, to the systems for responding when things go wrong.

50 We believe that one development in particular is called for. At the level of individual trusts, we take the view that an executive member of the board should have the responsibility for putting into operation the trust's strategy and policy on safety in clinical care, so as to protect the safety of patients. Further, a non-executive director should be given specific responsibility for leading the strategy and policy aimed at securing safety in clinical care. This concern for safety should be linked to existing systems for clinical governance, by ensuring that this non-executive director also serves as the Chair of the board's clinical governance committee. Through this leadership, the attention of all healthcare professionals will be directed towards safety. It will be the responsibility of all. It may also be helpful to note here, in the light of what we learned from the events of Bristol, that it must be made clear that, should it ever arise, the chief executive has the duty and the authority to close down even on a temporary basis a particular service if it poses too great a threat to the safety of patients. We describe in the next chapter a process by which trusts should be validated, rather than inspected, by CHI. It should always be open to trust chief executives, in pursuit of their duty to protect patient safety, to call in CHI to advise on whether a service or a facility is unsafe.