The Moment of Patient Safety: Iatrogenic Injury, Clinical Error and Cultures of Healthcare in the NHS

Abstract

Summary This article explores the ‘the moment of patient safety’—the period around 2000 when patient safety became a key policy concern of the British National Health Service (NHS), and other healthcare systems. While harm caused by medical care (iatrogenic injury) had long been acknowledged by clinicians and scientists, from 2000 a new systemic language of patient safety emerged in the NHS that promoted novel managerial and regulatory approaches to patient harm. This language reflected the state’s increasing role in regulating healthcare, as well as the erosion of medical autonomy and the rise of new forms of bureaucratic management. Acknowledging a transnational, intellectual context behind the rise of policy interest in patient safety—for example, the application of insights from the industrial safety sciences—this article examines the role played by domestic cultural factors, such as medical negligence litigation and healthcare scandals, in helping to define the new language in Britain.