“First do no Harm”?

So last week I have managed to get into the weeds of the data around patient harm in England, and there were a couple of things that struck me. Firstly, the vast number of incidents reported and secondly, the vast number of incidents reported!

While this might seem like repetition, there is an important point here. Since the inception of the National Reporting and Learning System there have been over 22.7m incidents recorded, with currently around 2m incidents being reported every year. One of the main tenets of healthcare across the world is “Primum non nocere” which translates to “first, do no harm”. So, can we really say that we are living and breathing that tenet within the NHS if we have had over 22 million incidents culminating into near misses or harm?

The simple answer to this question is a resounding Yes. In my 15-year career within the NHS I have never once met anyone who has come to work to intentionally cause harm. While there have been cases in the media of such events, these are thankfully very rare. This attests to my second statement…. the reason that there is a vast number of incidents reported is because of two things – the first is that humans are fallible and second is that we want to learn from our mistakes.

It is through the reporting of incidents to the NHS national patient safety team and through the analysis of such incidents that we will improve the care we give to our patients across England.

So perhaps it is finally time to change the dictum of “Primum non nocere” to “Primum non voluntariam nocere” – First do no intentional harm?