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HSE change ‘risks undermining open disclosure’

The Medical Protection Society (MPS) has described the HSE’s proposed definitions of 'a patient-safety incident' and 'harm' as too broad.

MPS said that the new definitions, outlined by the HSE as part of a review of its open-disclosure policy, could risk undermining the concept of open disclosure.

The HSE’s open-disclosure policy commits it to communicating with patients in “an open, honest, timely and transparent manner” if something goes wrong with their care.

Increased workload

In its response to a consultation process, the society said that the definitions would lead to any side-effect of investigation or treatment, or any unfavourable outcome of an illness, being categorised as a harm or a patient-safety incident.

They would therefore be subject to the open-disclosure policy.

MPS, which provides support for 16,000 healthcare professionals in Ireland, said that this would lead to a “significant and unnecessary” increase in the amount of work for healthcare professionals and providers.

The society has called on the HSE to ensure that the premise of a patient-safety incident or harm for open-disclosure purposes is instead based on error and ‘near misses’.

‘Bureaucratic endeavour’

Dr Rob Hendry (medical director at MPS) said that a mandatory open-disclosure process that relied upon such broad definitions would be “another bureaucratic endeavour”, and would add to the workload and pressure facing doctors.

“If a patient’s condition fails to improve, or continues to deteriorate, despite the best care and treatment, then this should not be categorised as a ‘patient-safety incident’ or ‘harm’,” he added.

MPS has also come out against the HSE’s suggestion that, when a patient declines the process of open disclosure, the patient can re-open the process within five years of refusal. The society believes that this period is too long, and wants it reduced to 12 months.