Shock­ing fig­ures show num­ber of peo­ple harmed by pre­scrib­ing er­rors

Manchester Evening News - - NEWS - By DAVID OTTEWELL

HUN­DREDS of peo­ple were harmed by pre­scrib­ing er­rors in Greater Manch­ester hos­pi­tals last year, with pa­tients not given medicine when needed or given the wrong dose or type of drug.

Staff at Greater Manch­ester health trusts re­ported 1,990 pre­scrib­ing er­rors to an NHS watch­dog last year.

At one trust – Stock­port NHS Foun­da­tion Trust – 273 er­rors were found.

They led to 44 pa­tients be­ing harmed and one per­son dy­ing.

The death came af­ter a pa­tient with mul­ti­ple car­diac con­di­tions did not have the cor­rect med­i­ca­tion pre­scribed ei­ther be­fore, dur­ing or af­ter surgery.

Three days later, and af­ter some de­lays es­ca­lat­ing to crit­i­cal care she de­vel­oped multi-or­gan fail­ure and died in in­ten­sive care.

Of those harmed at the trust, 25 were a low level of harm (re­quir­ing ex­tra ob­ser­va­tion or mi­nor treat­ment), 15 were a mod­er­ate level (can lead to fur­ther treat­ment, pos­si­ble sur­gi­cal in­ter­ven­tion, can­celling of treat­ment, or trans­fer to another area), and four were se­vere (the pa­tient was per­ma­nently or longterm dam­aged). Manch­ester Univer­sity NHS Foun­da­tion Trust saw 684 pre­scrip­tion in­ci­dents re­ported to NHS Im­prove­ment – which led to 32 pa­tients be­ing harmed and one death.

A de­scrip­tion of the pre­scrip­tion er­ror that caused a death were not recorded on the NHS sys­tem – just the side ef­fects.

The fig­ures – re­leased un­der free­dom of in­for­ma­tion laws – show that more than a fifth (21 per cent) of the pre­scrip­tion er­rors that took place in Greater Manch­ester NHS trusts in­volved pa­tients be­ing given the wrong dosage.

A fur­ther 16pc of in­ci­dents oc­curred when the pa­tient wasn’t given their med­i­ca­tion at all, or given it too late – while 9pc of er­rors in­volved pa­tients be­ing given the wrong drug en­tirely, and 9pc in­volved them be­ing given drugs at the wrong fre­quency.

Pre­scrib­ing er­rors are rel­a­tively com­mon and usu­ally re­sult in no harm or low harm to pa­tients.

How­ever they can re­sult in se­vere harm and even death.

An NHS spokesper­son said: “NHS staff dealt with over a bil­lion pa­tient con­tacts over the last three years, while se­ri­ous pa­tient safety in­ci­dents are thank­fully rare, it is vi­tal that when they do hap­pen or­gan­i­sa­tions learn from what goes wrong – build­ing on the NHS’ rep­u­ta­tion as one of the safest health sys­tems in the world.

“As part of the NHS Long Term Plan a medicines safety pro­gramme has been es­tab­lished, mean­ing more than ever be­fore is been done to en­sure safe medicine use, and nearly £80m been in­vested in new tech­nol­ogy to pre­scrip­tion sys­tems.”

Across English NHS trusts last year, 19 peo­ple were re­ported as dy­ing af­ter – but not nec­es­sar­ily be­cause of – pre­scrib­ing mis­takes, while a fur­ther 40 were recorded as be­ing se­verely in­jured and 532 were mod­er­ately in­jured.

The most com­mon type of er­ror was where medicine was | omit­ted, fol­lowed by wrong doses, and then the wrong drugs be­ing pre­scribed.

That’s not in­clud­ing the 4,036 cases which oc­curred in set­tings other than a trust (for ex­am­ple a com­mu­nity phar­macy, gen­eral prac­tice, etc.)

In to­tal there were more than 52,700 pre­scrib­ing er­rors in the English NHS in 2018.

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