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Distribution of litigation claims across a generalised psychiatric patient journey

  • Mark Mordue (a1), Marcus Weatherby (a2), Stuart Weatherby (a1) and Stephen Pearson (a3)
Abstract
Aims and method

We analysed all 1213 negligence claims made against contributing psychiatric services since the inception of the National Health Service Litigation Authority (NHSLA) in 1995 and until 1 June 2009. More than half (55%) were settled, at a cost of £47.2 million, 26% were closed without penalty and 19% were still in progress at the time of review. Five individual claims exceeded £1 million.

Results

By allocating 43 NHSLA-assigned causes for a claim to the 11 stages of a generalised patient journey, we noted that assessment of patient risks was the single largest cause of claims (32%) and the single largest cost of settlements (£16.2 million, 34%).

Clinical implications

At the individual level it is difficult to see patterns of errors, whereas increased volumes reveal systemic trends. This analysis presents a new perspective from which to improve patient safety.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Stephen Pearson (stephen.pearson@nhs.net)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 National Health Service Litigation Authority. Report and Accounts 2009. NHSLA, 2009 (http://www.nhsla.com/NR/rdonlyres/8304D093-F0B6-40BA-BB28-0E64872893E2/0/NHSLAannualreportandaccounts2009.pdf).
2 Tees and North East Yorkshire NHS Trust. Integrated Mental Health Electronic Record (IMHER) Pilot Process Modelling and Redesign Project. Tees and North East Yorkshire 2002, (http://www.publications.doh.gov.uk/ipu/socialcare/stocktonconsort/CD%20Docs/models/home.htm).
3 Department of Health. Departmental Report 2008: 148. Department of Health, 2008.
4 Baker, M, Thomson, R, Sandars, J. Learning from threats to patient safety. In ABC of Patient Safety (eds Sandars, J, Cook, G). BMJ Publishing Group, 2007.
5 Reason, J. Human error: models and management. BMJ 2000; 320: 768–70.
6 Scally, G, Donaldson, LJ. Clinical governance and the drive for quality improvement in the new NHS in England. BMJ 1998; 317: 61–5.
7 Geddes, JR, Juszczak, E. Period trends in rate of suicide in first 28 days after discharge from psychiatric hospital in Scotland, 1968–92. BMJ 1995; 311: 357–60.
8 Gunnell, D, Hawton, K, Ho, D, Evans, J, O'Connor, S, Potokar, J, et al. Hospital admissions for self harm after discharge from psychiatric inpatient care: cohort study. BMJ 2008; 337: a2278.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Distribution of litigation claims across a generalised psychiatric patient journey

  • Mark Mordue (a1), Marcus Weatherby (a2), Stuart Weatherby (a1) and Stephen Pearson (a3)
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