ONE in ten patients admitted to NHS hospitals will fall victim to medical errors, which have now become Britain’s fourth-biggest killer.

Medical accidents and errors contribute to the deaths of 72,000 people a year, and they are directly blamed for 40,000. They also cost the NHS £2 billion in increased hospital stays alone.

However, fewer than a third of an estimated 900,000 annual mistakes are properly reported, an independent audit reveals today.

The report by the healthcare research group Dr Foster highlights both the scale of medical error in the NHS and the extent to which the system for reporting them is failing.

Roger Taylor, research director of Dr Foster, said: “Compared with the transport industry, the number of errors causing very high levels of death is extraordinary.”

Action Against Medical Accidents, a charity which helps victims of medical negligence, said: “The research confirms our experience of an alarming rate of errors occurring in our NHS. The figures do not even include errors occurring in primary care, such as in GPs’ surgeries, and are likely to be significantly less than the actual rate as they are only based on reported errors.

“Our experience is that all too often the health provider does not even recognise that a mistake has been made. The vast majority of clinical negligence claims which end up being successful are robustly defended by the NHS.”

The Dr Foster study, which is published today in the British Medical Journal, shows that the number of mistakes to which NHS hospitals openly admit is a small fraction of the total accepted by the Government’s patient safety watchdog.

It found that only 276,514 errors were recorded each year by English hospitals, even though the National Patient Safety Agency (NSPA) puts the true figure at closer to 900,000.

Approximately 25 per cent of errors occur during surgery, and another 25 per cent in diagnosis or pre-care. The other half of all mistakes are made during treatment on the ward. They can range from providing patients with inadequate nutrition to prescribing the wrong dose of medication.

The figures do not include any hospital-acquired infections or complications of childbirth, and almost 10 per cent of the trusts surveyed claimed an unlikely error rate of zero.

“It shows there is not enough transparency,” Mr Taylor said. “Sometimes no one ever finds out if a patient died as a result of something going wrong — it may never go outside the group involved in that patient’s care.

“We need to increase pressure and encourage organisations to make this a top priority. People would be concerned about flying with an airline which had two crashes. That’s an infinitessimal risk when compared with a problem of this magnitude. It’s an absurd situation.”

Research around the world has indicated that most hospitals have an error rate of about 10 per cent, and that about half these incidents could have been prevented.

Dr Foster analysed more than 50 million “episodes” of patient care, defined as a period spent under the supervision of one doctor, and found 276,514 were recorded as involving an adverse event. This rate of 2.2 per cent clearly underplays the true extent of the problem, the researchers said.

The NPSA estimates that medical errors contribute to around 72,000 deaths each year, making them the fourth leading cause of death after cardiovascular disease, cancer and respiratory conditions.

Male and elderly patients are the most likely to be affected, the Dr Foster report found. Many mistakes are caused by a bewildering range of equipment that is used in the same hospitals: a recent NPSA study, for example, found that most trusts use 31 different types of intravenous drip.

NHS trusts are now required to have a “no-blame” reporting system for adverse events involving error, but doctors and experts said this is not yet working smoothly.

Mr Taylor said: “There’s a culture of ‘well we’re all working very hard and it’s inevitable that these things happen’. To the public that is shocking. The only barriers to recording this information properly are ones of will, politics and breaking down culture. A doctor’s perception of this problem is very different from the man in the street.”

Edwin Borman, deputy chairman of the British Medical Association consultants’ committee, said: “These findings are not a surprise. We have to crack this issue of reliable reporting by introducing a true no-blame culture, which we haven’t acknowledged yet properly in the UK. The system is still paper-based, and it gets swamped.” Sarah Teather, a Liberal Democrat spokeswoman on health spokesperson, said a no-fault compensation scheme was needed if the NHS is to make progress on the issue.

“A no-blame reporting system is no good without a compensation system to match,” she said. “At the moment doctors face quadruple jeopardy. They face disciplinary action with hair-trigger suspensions, the police can get involved, they can be referred to the GMC and there is the prospect of tort.”

The NPSA said: “The agency welcomes this study and fully supports the conclusion that hospitals should be encouraged to improve the recording and reporting of adverse events.

“Only by gathering information from the widest possible range of sources can we establish the most accurate picture possible of patient safety issues and take steps to make the NHS safer for patients.”

A spokesman for the Patients’ Association said: “We must have confidence that any harm to patients is avoided but with such poor recording, including not having specific records for MRSA or other hospital-aquired infections, the figures suggest the tip of a much bigger iceberg.”

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