Healthcare-Related Harm Affects One in 10 NHS Patients

Almost one in 10 people reported experiencing harm from NHS care in the past 3 years, according to a survey led by the University of Oxford. 

The study, published in BMJ Quality & Safety, found that 9.7% of respondents reported harm, with 6.2% attributing it to the treatment or care received, and 3.5% citing lack of access to services.

Researchers noted that these findings exceed those of two previous British surveys which reported harm rates of 4.8% in 2001 and 2.5% in 2013. While acknowledging that the pandemic’s impact on healthcare access may have contributed to the higher figures, they said that the study highlights issues that “may be hidden from official data on patient safety”. 

As well as the withdrawal of medical care attributed to the pandemic, the increase could also be explained by using a broader definition of harm to include psychological as well as physical harm, the study authors suggested.

Assessing Patient Harm

The survey, conducted between November 2021 and May 2022, involved telephone interviews with over 10,000 individuals. Participants were asked about harm experienced between November 2018 and May 2022 – a period when most pandemic restrictions had ended.

Previous studies had indicated rising harm rates before the pandemic. For example, a 2019 meta-analysis of 70 studies involving nearly 350,000 patients found patient harm prevalence at 6%, with total harm reaching 12%. An accompanying editorial noted that the study raised “serious concerns about the safety of health systems”.

Lead author of the new study, Dr Michele Peters, PhD, a medical sociologist at the University of Oxford, told Medscape News UK : “In the past, harm has usually been measured using clinical rather than patient perspectives.” She explained that this emphasis tended to highlight harm associated with clinical errors rather than harm related to system issues, such as long waits for treatment. 

The latest study is one of the first to explicitly assess actions taken following harm due to lack of access to care. Around half of those awaiting treatment experienced physical or psychological consequences, with longer waits more common in deprived areas.

“Current waiting list management approaches do recognise that some people are particularly vulnerable to deterioration during the waiting period,” Peters told us. This means they may end up in poor condition when called for treatment. She noted that some interventions, such as weight management or smoking cessation support, aim to maintain patients’ health while they wait for procedures like hip replacements.

Few Patients Seek Compensation

Among those affected, 37.6% reported moderate harm, while 44.8% experienced severe harm. However, most patients did not seek financial compensation. Instead, they prioritised getting treatment or care to help recover, or access to the treatment that they had not had.

Just over 21% of those harmed said they avoided claims because they did not want to take action against the NHS. Another 18% stated they did not want financial compensation. Instead, nearly 60% sought professional advice or shared their experiences with family and friends. 

“This means there are opportunities for people to be supported in the aftermath of harm that do not involve the challenges or burdens of litigation,” Peters said.

Some patients remain loyal to the NHS, despite reporting harm, perhaps owing to other experiences of good care, she suggested. “People realise that the NHS is a complex organisation and that quality of care, and indeed safety, will vary across providers,” she said. 

Barriers to Taking Action

Many patients faced obstacles in seeking redress. Some were deterred by the complexity of the process or concerns about being labelled difficult. Others worried about potential consequences for their future care. “Taking action requires time and energy, as well as confidence in navigating complex processes,” said Peters. Many patients did not feel heard by professionals when they raised concerns, “and they may need to be quite insistent for their concerns to not be dismissed”. 

A more open system for patient feedback, including negative experiences, could help patients feel more comfortable raising concerns, she added.

NHS Response 

Asked to comment on the study’s findings, an NHS spokesperson told Medscape News UK: “This survey reflects people’s personal experiences during the exceptional circumstances of the pandemic period,” which were “unprecedented”. “It is based solely on individual perceptions and experiences during telephone interviews, rather than clinically reported harm.”

They added that there was no standardised definition of severe harm used in the study.

The spokesperson added: “The NHS has made significant progress in strengthening patient safety – including a nationwide programme of training and education – and we recognise there is still more to do to improve care for patients by providing better access to services and reducing health inequalities.”

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.