I trained as a clinical psychologist and worked in the British NHS for several years. Since 1985 I have focused on conducting research on the causes of harm to patients, the consequences for patients and staff and methods of improving the safety of healthcare. I established the Clinical Risk Unit at the Department of Psychology, University College London where I was Professor of Psychology. In 2002 I moved to become Professor of Clinical Safety Research in the Department of Surgery and Cancer at Imperial College in 2002. From 1999 to 2003 I was a Commissioner on the UK Commission for Health Improvement. I have acted as an advisor on patient safety in many inquiries and committees including the Bristol Inquiry, the Parliamentary Health Select Committee, the Francis Inquiry and the Berwick Review. From 2007 to 2013 I was the Director of the National Institute of Health Research Centre for Patient Safety & Service Quality at Imperial College. I moved to the Department of Experimental Psychology in January 2014 with the support of the Health Foundation to continue my work on safety in healthcare.
M Phil PhD
Professor of Psychology
- NIHR Senior Investigator
- Emeritus Professor Clinical Safety Research, Imperial College London
My research is concerned with understanding how healthcare can become safer. While healthcare brings huge benefits errors are frequent and many patients come to some harm during their care. This area of work is now usually described as ‘patient safety’. Much of my early research was aimed at understanding why things go wrong in healthcare and developing methods of analysing the problems that occur. We also found that about 10% of patients in British hospitals suffer some kind of harm during their care, about half of which is preventable. All other healthcare systems have similar problems not just the NHS. My colleagues and I have also studied teamwork in the operating theatre and in other contexts as good teamwork is essential to safe, high quality care. We have developed methods of measuring teamwork and training programmes using simulation to enhance teamwork skills. I also have a longstanding concern about the effect of errors on both patients and staff. Patients can suffer a variety of psychological problems after medical error in addition to any physical effects. The impact on staff is also considerable. For instance surgeons may suffer great anguish when they feel responsible for the death of injury of a patient.
Most studies and practical patient safety initiatives have been based in hospitals. A major challenge for the next few years is to improve safety in mental health, community services and primary care. For instance many admissions to hospital are due not to disease but to people in the community responding badly to prescribed medication. My current work with the Health Foundation covers three broad areas. First, to develop methods of studying and improving patient safety in community settings. Second, to develop ways of measuring and monitoring safety in NHS and other healthcare organisations. Third, to study how regulation in healthcare contributes to safety and also how it can potentially stifle safety improvement.
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