NHS managers risk court over clinical errors

NHS managers should be legally responsible for some clinical negligence cases, a patient safety expert has argued.

Brian Toft, a professor of patient safety at Coventry University and incident investigator, believes that where healthcare professionals have told managers about a problem with their care environment, the manager should be liable for incidents related to the problem.

He gave the example of clinicians complaining of being overloaded with patients and later making a mistake which harms someone.

Professor Toft, who has advised the World Health Organisation and the National Patient Safety Agency, said having formally told management about an issue could be used as a defence by a professional and as an argument to prosecute a manager.

“When you are under so much pressure you are absolutely going to make mistakes. If the system of work forces people so they can’t cope and therefore miss errors it shouldn’t be the people who make the error who are held responsible, if they have already told their manager.

“They have to tell them formally in writing. If the manager takes no responsibility then it should be [the manager] that ends up in court.”

Unsafe environment

Professor Toft said some investigations of major clinical errors in the past had blamed clinicians where the problem was really the fault of their environment.

But Managers in Partnership chief executive Jon Restell said: “Any employee who raises safety concerns is discharging their responsibility. Managers are already responsible. Professionals still have a responsibility for their actions as well. I don’t think managers are under any greater obligation [than before].”

An article by Professor Toft and Cardiff academic Peter Gooderham in the academic journal Quality and Safety in Health Care argues that if a manager ignores a warning from a professional, they are “consciously taking a risk which places the healthcare professional’s patients in harm’s way”.


Health Direct points out that labour has abdicated it’s “authority” and accordingly is throttling the NHS with red tape.

On Wed, Feb 18, 2009- we posted: NHS managers voice worries over ‘Stalinist’ SHA tactics

The zero tolerance culture for failure has made some chief executives fear for their jobs as a “Stalinist” culture is draining the NHS of experienced chief executives and making trusts insular and risk averse, Health Direct has learnt from senior leaders.

If someone asked me for views as to whether they should apply for a chief executive’s post, I’d say I wouldn’t touch it with a barge pole”.

Many also feel the shake-up will discourage people from applying for top jobs at a time when vacant posts often attract just one candidate.

Labour has now created a classic- Not My Fault, Guv environment where no one is in charge. Not the politicians, not the doctors or clinicians and not the paperpushing managers.

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