Hospital 'failed to protect'

Plymouth Hospitals NHS Trust has been told to make urgent improvements to protect patients undergoing surgery at Derriford Hospital by health watchdog the Care Quality Commission, following an unannounced inspection.

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What is a 'never event'?

A 'never event' is a serious, preventable mistake made by healthcare staff that puts the patient at serious risk of harm or death.

To be a 'never event', an incident must fulfill the following criteria:

  • The incident has the clear potential for, or has caused severe harm or death
  • There is evidence of occurrence in the past (i.e. it is a known source of risk)
  • There is existing guidance to prevent the event
  • The event is largely preventable if the guidance is implemented

Announced inspectors at Derriford Hospital in Plymouth discovered eight 'never events' during their two week visit.

  • Seven of the incidents took place in theatre
  • Four of the incidents included wrong site surgery: i.e surgeons operated on the wrong part of a patient's body

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