World Patient Safety Day: what role for HIFA? (7) Patient power sharing in health care provision (2)

24 September, 2020

The WHO patient safety does include a good amount about health information and education for all patients, families and communities and about the information supporting the emerging roles of patients, families and communities as actors and agents in the management of their own health and ongoing diseases. I have pasted the sdalient points from the WHO patient safety draft from a report that I passed on to our UK General Medical Council:


Treat patients and families as partners in safe care

Safe health care should be seen as a basic human right. Achieving safe care requires that patients be informed, involved, and treated as full partners in their own care. In many parts of the world, this happens much less than it should. Patients, families and care givers have a keen interest in their own health and that of their communities. Patient safety depends on their full involvement as the users of the health care system and the people who are most familiar with the entire patient journey. Patients and families should be involved at every level of health care, from policy-making and planning committees, to performance oversight, to fully informed consent and shared decision-making at the point of care. Patients, families and communities have essential contributions to make in patient safety.

Engage and empower patients and families to help and support the journey to safer health care.

A high proportion of the patient safety incidents that occur in health care systems around the world is because of flaws in the design or operation of clinical processes. Prominent among these reasons is failure to communicate well with the patient.

Improving critical communication amongst health care professionals and with patients is crucial and would prevent millions of adverse events.

Engage and empower patients and families to help and support the journey to safer health care. Patient engagement and empowerment is perhaps the most powerful tool to improve patient safety. Patients, families, and other informal caregivers bring insights from their experiences of care that cannot be substituted for, or replicated by, clinicians, managers or researchers. This is especially so for those who have suffered harm. Patients, families, and caregivers can serve as vigilant observers of a patient�s condition and can alert health care providviders when new needs arise. Given proper information, the patient and family can help to be the eyes and ears of the system.

The group issued the London Declaration, outlining four broad areas of action including: Devising and promoting programmes for patient safety and patient empowerment; Co-production with patients builds a strong foundation for health care system improvement.

Patients travel through the entire health care system, so they are more likely, than providers, to have a holistic view of it rather than be focused on one small part of the system. Patients and families are the end users of the health care system. They are often the only ones to have full insight into the outcome of their care. Their perspective on how care can be made safer is invariably very valuable. The intense public and personal interest in, and knowledge of, health could be harnessed to make patients more frequent partners in improving patient safety.

WHO recommends

Engaging and empowering people and communities; Much is made of the current emotional distance and empathy gap between patients and health professionals who provide their care.

Patient and family engagement needs to be made an integral part of patient safety: as a pillar of health care practice, by building it into every health care organizational and governance structure, by having it a subject of community and national oversight.

Most importantly, patients need to be given the information that they need to manage their own care and take charge of their safety to the greatest extent possible. Health care institutions, supported by national and international entities, should commit to policies to promote transparency to patients, including fully informed consent, patient access to medical records, and full disclosure if patients are harmed by their care.

Actions for governments

Create formal mechanisms to include patients and families in national governance mechanisms, working groups, task forces, and committees that plan and take action to improve patient safety in the country.

Embed patient engagement standards in accreditation.

Actions for governments

Develop national guidance for informed consent, for patient access to their medical records, and for patient/family ability to escalate care if they perceive a patient to be deteriorating. Develop a guidance framework and procedures for enabling health care providers to disclose to patients and families the adverse events that have caused (or could have caused) inadvertent harm.

Consider introducing legislation on disclosure policies to inform patients and families, where guidance has not been effective.

Actions for Health Care Facilities

Develop institutional policies for robust informed consent, for patient access to their medical records,


HIFA profile: Richard Fitton is a retired family doctor - GP, British Medical Association. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data. Email address: richardpeterfitton7 AT