European Supervisory Bodies and Patient Safety

1. European Supervisory Bodies and Patient Safety First results presented by Sandra Eismann (CQC)

2. Research proposal • Objective: • The study aims to identify and compare the overall approach European health regulators take in regulating and assessing patient safety; and to identify further areas for collaborations between EPSO (European Partnership for Supervisory Organizations in Health Services and Social Care) members.

3. EPSO working group • Jan Vesseur/ Dutch Health Care Inspectorate • Geir Sverre Braut/ Norwegian Board of Health Supervision • Vaida Momkuviene/ Lithuanian State Medical Audit Inspectorate • Katja Peters/ Academy of Public Health in Düsseldorf • Sandra Eismann/ Care Quality Commission England

4. Our early thinking …. • Possible themes to follow up in the questionnaire: • What are the different tasks supervisory bodies undertake in relation to patient safety (e.g. system(s) for notification of events)? • What mandatory safety related reporting is in place in the different countries, and what information is published for patients? • In the different countries, which patient safety initiatives were evaluated and which were most effective? • Focus on hospitals and/or residential settings? •  the survey should be a starting point for future collaborations.

5. Some focus on adverse events and incident reporting Injuries caused by medical management as opposed to the patient’s underlying disease process (Mello et al. 2005) Others include organisational leadership, clinical engagement, work-place safety and other, which all contribute to patient safety outcomes. Defining patient safety

6. Patient Safety Initiatives • Questionnaire – Part A • What initiative or policy for improving patient safety in hospitals is currently taking place in your country? • What is the role of your organisation in the initiative?

7. Responses from 15 countries/regions • Scotland • Slovenia • Estonia • Ireland • Denmark • Germany • Finland • Sweden • Norway • Netherlands • Belgium • France • Lithuania • Northern Ireland • England

8. Patient Safety Initiatives • Patient safety programmes aiming explicitly to reduce adverse events or mortality rates • Scottish Patient Safety Programme aims to reduce adverse events by 30% and mortality rates by 15% • NHS Quality Improvement Scotland leads and co-ordinates initiative • A programme to reduce preventable harm and death in 5 years by 50% • Dutch Health Care Inspectorate assess progress of implementation

9. Patient Safety Initiatives • Wider quality management programmes, including patient safety: • Initiatives include creating a safety culture, reviewing governance structures, communication and education, sharing learning, include hospital as well as primary health services • Lithuania: State Medical Audit Inspectorate measures implementation • Northern Ireland: RQIA conducts reviews and reports on the quality of care • England: CQC used information for its own regulatory activities • Estonia: Health Board performs surveillance and enforcement functions • Norwegian Board of Health Supervision integrates some initiatives into own regulatory activities • France: HAS oversees implementation of process

10. Patient Safety Initiatives • Patients Rights/ Ombudsman • Slovenia: HIRS deals with offences under the act • Denmark: National Board of Health receives information from ombudsman and undertakes disciplinary sanctions • International/bilateral initiatives • European Union Network for Patient Safety (EUNePaS), includes all 27 member states • Health Information and Quality Authority is coordinating agencies for Ireland • EurSafety Health-net for Patient Safety and Infection Protection • German Dutch co-operation/ Academy of Pubic Health offers guidance and training

11. Patient Safety Initiatives • Projects on patient safety • Pilot projects around quality management and patient safety • Belgium: incorporated in auditing activity • National project on patient safety led by SALAR in Sweden • National Board of Health and Welfare in dialogue with SALAR • Additionally: National Board of Health and Welfare starting project on supervising providers in regards to infection control • Guidance issued on importance of patient record keeping • Finland: VALVIRA issues guidance and lectures in healthcare organisations

12. Patient Safety Initiatives - Summary • What initiative or policy for improving patient safety in hospitals is currently taking place in your country? • Patient safety programmes aiming explicitly to reduce adverse events or mortality rates • Wider quality management programmes, including patient safety • Patients Rights/ Ombudsman • Projects on patient safety

13. Patient Safety Initiatives - Summary • 2. What is the role of your organisation in the initiative? Measuring progress of implementation Including information into own regulatory activity Coordinating Proving guidance and training Leading the initiative Following up complaints

14. Focus on patient safety • Questionnaire – part B • Question 3: • When regulating/ supervising hospitals, do you focus specifically on patient safety, or is it part of everything that you do? • When regulating/ supervising hospitals, which areas of patient safety do you look at?

15. Focus on patient safety - summary • When regulating/ supervising hospitals, do you focus specifically on patient safety, or is it part of everything that you do? • We focus specifically on patient safety (5) • Germany, Netherlands, Scotland, Northern Ireland, Sweden • Patient safety is a theme with runs through everything we do (12) • Lithuania, Norway, Netherlands, England, Estonia, France, Slovenia, Denmark, Sweden, Finland, Ireland, Belgium • We do not focus on patient safety (1) • Lithuania

16. Focus on patient safety - summary When regulating/ supervising hospitals, which areas of patient safety do you look at? 14 responses (excluding Denmark)

17. Infection control • How do you supervise/ regulate hospitals’ infection control? • Which organisation in your country is setting quality standards or developing guidelines in regards to infection control? • What are you are assessing in regards to infection control? • Evidence gathering and analysis • Outcome of your activity

18. Next steps • Draft paper • Circulate within working group • Final paper • If you have any questions, comments or would like to see the draft paper please e-mail me: • sandra.eismann@cqc.org.uk