Patient-reported harm from NHS treatment or care, or the lack of access to care: a cross-sectional survey…, 2025, Crocker et al.

[Chandelier]

Patient-reported harm from NHS treatment or care, or the lack of access to care: a cross-sectional survey of general population prevalence, impact and responses

Spoiler: Authors

Crocker, Helen; Cromwell, David A; Modha, Shivali; Gray, Alastair McIntosh; Graham, Chris; Thana, Lavanya; Fitzpatrick, Raymond; Vincent, Charles; Hogan, Helen; Peters, Michele

Abstract​

Objectives The aim of this article is to provide an estimate of the proportion of the general public reporting healthcare-related harm in Great Britain, its location, impact, responses post-harm and desired reactions from healthcare providers.
Design We used a cross-sectional survey, using quota sampling.
Setting This research was conducted in Great Britain.
Participants The survey had 10 064 participants (weighted analysis).
Results In our survey 9.7% participants reported harm caused by the National Health Service (NHS) in the last 3 years through treatment or care (6.2%) or the lack of access to care (3.5%).
The main location where the harm first occurred was hospitals.
A total of 37.6% of participants reported a moderate impact and 44.8%  a severe impact of harm.
The most common response to harm was to share their experience with others (67.1%). Almost 60% sought professional advice and support, with 11.6% contacting the Patient Advice and Liaison Service (PALS).
Only 17% submitted a formal complaint, and 2.1% made a claim for financial compensation.
People wanted treatment or care to redress the harm (44.4%) and an explanation (34.8%).
Two-thirds of those making a complaint felt it was not handled well and approximately half were satisfied with PALS.
Experiences and responses differed according to sex and age (eg, women reported more harm).
People with long-term illness or disability, those in lower social grades, and people in other disadvantaged groups reported higher rates and more severe impact of harm.
Conclusions We found that 9.7% of the British general population reported harm by the NHS, a higher rate than reported in two previous surveys.
Our study used a broader and more inclusive definition of harm and was conducted during the COVID-19 pandemic, making comparison to previous surveys challenging.
People responded to harm in different ways, such as sharing experiences with others and seeking professional advice and support.
Mostly, people who were harmed wanted help to redress the harm or to gain access to the care needed.
Low satisfaction with PALS and complaints services may reflect that these services do not always deliver the required support.
There is a need to better understand the patient perspective following harm and for further consideration of what a person-centred approach to resolution and recovery might look like.

Web | DOI | PMC | PDF | BMJ Quality & Safety | Open Access

 

[Chandelier]

We asked 10,000 people if the NHS had harmed them physically or emotionally in recent years. This is what we found...

In this blog, Michele Peters, Associate Professor from the University of Oxford, shares findings from a research project that focused on patient harm in the NHS.

www.pslhub.org

We asked 10,000 people if the NHS had harmed them physically or emotionally in recent years. This is what we found...

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Summary​

In this blog, Michele Peters, Associate Professor from the University of Oxford, shares findings from a research project that focused on patient harm in the NHS.​

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Content​

The NHS is designed to help people get better, not make things worse. Patients reporting harm they have experienced, should help the NHS to fix the problems that really matter. However, the patient perspective of harm is scarcely researched which means an important perspective of safety in the NHS is missing.​

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In 2021-2022, the University of Oxford and London School of Hygiene conducted a study with 10,000 people in the UK to find out:​

• how often people report being harmed by the NHS
• how the harm affected their health
• what do people do after being harmed
• what would people like after the harm.

Nb: Figures have been rounded​

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[Maat]

People with long-term illness or disability, those in lower social grades, and people in other disadvantaged groups reported higher rates and more severe impact of harm

Clinical record reviews are also less able to identify psychological and/or social harm. Patients are at the centre of treatment and able to observe the whole process of care. As such they are uniquely placed to fill important gaps in understanding and conceptualising harm and devising person-centred healthcare.

Studies of the prevalence of harm in the general population are relatively rare. Results from a survey of residents in a region of Norway suggested 9.4% of men and 9.9% of women experienced care that led to the worsening of their health. In Great Britain, two population-based surveys identified that rates of healthcare-related harm fell from 4.8% in 2001 to 2.5% in 2013 but severity remained stable with around half reporting permanent or major disability as a result.

People’s responses after harm are often attempts to mitigate and promote recovery, commonly including a search for meaning and turning to family, friends, community and health professionals for support. Healthcare professionals’ failure to listen, learn or provide necessary support are known to compound the original harm and delay recovery

I'm in the process of trying to recapture and organise my thoughts for a discussion on patient safety, the medical law and ethics surrounding informed consent, and what seems to be emerging as a concept of something termed 'evidence based consent' being suggested in recent Norwegian research - and how this is being connected with cultural social media.