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Nine in ten doctors think learning without blame is key to improving patient safety

15 September 2021

The overwhelming majority of South African doctors (92%) believe healthcare workers must be in an environment where they can admit errors, apologise and learn from mistakes without fear of personal recrimination, if patient safety is to be continuously improved.

This is according to a survey of 590 doctors, carried out by Medical Protection – the world’s leading protection organisation supporting more than 30,000 healthcare professionals in South Africa.

Medical Protection said the survey results bring into sharp focus the need for the Government and healthcare leaders to aid a shift to a more open, learning culture in healthcare, where healthcare professionals are supported to discuss and learn from mistakes, and patients are subsequently better protected and better informed in the future.

The organisation said that fear of blame, regulatory action or even criminal charges following an adverse incident is currently a barrier to open disclosure, which must be broken down.

Dr Graham Howarth, Head of Medical Services – Africa said: “Doctors want to do their very best for patients, but medicine is not an exact science. Day in day out doctors make complex decisions often in fast moving or pressured circumstances. This means complications and errors can sometimes arise.

“If an error does occur, the practise of open disclosure should mean that the patient or their family is told, usually by the treating clinician, and receives a sincere apology and full explanation. This process also enables lessons to be learned to avoid a reoccurrence. Additionally, patients are better informed about their care.

“A culture of fear and blame across the South African healthcare community is however currently a barrier to open disclosure and to a more open, learning environment being embraced. If we are to make continuous improvements to patient safety, it is a barrier that simply must be broken down.

“These survey results show the real strength of feeling on this issue from healthcare professionals.

“Medical Protection plays a role in helping to create a more open, learning culture in healthcare. Our risk prevention programme equips members with a range of resources and training to combat the common causes of complaints and claims, including through improved communication. Medical Protection also advises members that they should be open and honest with patients, that it is often appropriate to communicate regret and empathy following an adverse outcome, and that doing so is not necessarily an admission of liability.

“Medical Protection is calling on healthcare leaders, hospitals, the Government and individual clinicians to take active steps to further aid a shift to a culture of openness and learning, in which healthcare professionals feel able to apologise, discuss and learn from mistakes without fear of personal recrimination.

“This would ultimately help to prevent errors from reoccurring, improve patient safety in the future, and the increase in transparency may even help to reduce the number of claims and complaints brought against healthcare professionals when something goes wrong.”


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Notes to editors

The survey was conducted by Medical Protection in mid-2021 and achieved 590 responses from medical practitioners and trainees in South Africa.

The respondents were asked to what extent they agreed with the statement ‘If we are to continually improve patient care, all healthcare workers need to be in an environment where they feel confident to admit errors, apologise and learn from mistakes without fear of blame.’

The majority of respondents – 77 percent – strongly agreed with the statement, with 15 per cent saying they somewhat agree, 2 percent neither agreeing nor disagreeing, 1 per cent somewhat disagreeing and 6 percent stating they strongly disagree.

About Medical Protection

Medical Protection is a trading name of The Medical Protection Society Limited (“MPS”). MPS is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of almost 300,000 members around the world. Membership provides access to expert advice and support and can also provide, depending on the type of membership required, the right to request indemnity for any complaints or claims arising from professional practice.

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations.

MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.