Mistakes in medicine
SIR – We can reassure Richard Statham (Letters, January 30) and Pat Blenkinsop (Letters, February 1) that the Confidential Reporting System for Surgery (Coress) has been in operation for the past decade.
Coress is based on the same model as the one that has been successful in aviation. It is a charity, independent of employers or other vested interest. It publishes anonymised vignettes of safety episodes in the surgical press, as an educational service to surgical teams. Absolute confidence – with no repercussions for an honest account – is vital for reporting errors or nearmisses. Such trust takes time to build and is easily damaged.
There is little use in “directing” staff to report such incidents. Not infrequently, only one person is involved and the incident remains unknown to everyone else. If that individual keeps it to themselves, then the opportunity for others to learn is lost. For every medical or surgical catastrophe, there will have been a number of near-misses or precursors that, had they been identified, could have driven change in the system. Lord Ribeiro
Chairman, Board of Trustees, Coress Professor Frank C T Smith Programme Director, Coress Peter Tait
Former CEO, Confidential Human Factors Incident Reporting Programme Denis Wilkins
Former president, Association of Surgeons of Great Britain and Ireland
SIR – Recent letters (February 3) have discussed medical negligence and compensation.
In 20 years of providing objective, independent medical reports for claimants and defendants, I have seen three basic recurring problems. There are failures of communication from doctor to doctor, doctor to nurse, and doctor to patient and relatives. There are also deficits in the continuity of care.
However, the biggest problem is the failure of doctors of all grades and specialities to remember the basics of their undergraduate bedside training, placing undue reliance on scan results even when these conflict with clinical observation and knowledge.
F D Skidmore FRCS
London SE3
SIR – I had an elective operation at the Great Western Hospital in 2006. It resulted in an impressive haematoma, which saw me back in theatre less than 10 hours later and in a ward for a further four nights.
When I went back to have the stitches removed, the consultant almost kissed me when I told him that I had no intention of pursuing legal action against him or the trust.
There is a gulf between negligence and happenstance. Surgery is risky. Those who use the NHS need to understand the difference better if our health care professionals are to feel free enough to do their best for us. Kevin Fiske
Hungerford, Berkshire