The Health Services Safety Investigations Body (HSSIB) is a fully independent arm’s length body of the Department of Health and Social Care. On 25 July, we published a report titled – ‘Workforce and patient safety: digital tools for online consultation in general practice.’ The investigation was launched after hearing concerns from patients and staff about potential risks to patient safety contributed to by the use of online tools for remote consultation. Despite limited incidents of harm having been reported to national systems, we listened to concerns and set out to understand the potential risks.
We saw the challenges faced by general practices when trying to meet increasing demand while delivering high-quality care. We also saw how patients were kept safe through the hard work of general practice teams navigating around and adapting to the challenges they faced. For some practices and their patients the introduction of online tools had provided benefits. However, for others implementation had created new risks to patient safety and impacted on the workload of staff. These risks were contributed to by the design, procurement and support for implementation of online tools that did not always meet the needs of patients and practices.
General practices are complex ‘sociotechnical systems’ where humans and technology interact with the goal of meeting patient needs and creating safety. Any implementation of new ways of working requires understanding of the complexity of these systems, support and recognition of the risks to patient safety. We found that the risks to patient safety were not always recognised nor was support always available to practices. As such we have made two recommendations to NHS England – 1) to explore the patient safety risks associated with online tools, and 2) to better enable integrated care boards to support general practice to effectively and safely implement online tools. With the future likely to include increasing use of digital healthcare comes the need to be proactive – national organisations have a key role in supporting general practice to implement online routes for care in the most safe and effective way.
For those working in general practice and are new to the HSSIB – Our role is to investigate patient safety concerns across healthcare in England without finding blame or apportioning liability. We publish our investigations and make recommendations to national bodies to influence improvements in patient safety. Under the Health and Care Act 2022 we have various powers and a responsibility to not disclose certain information – this creates a ‘safe space’ for staff to talk to us about their concerns.