Digital clinical safety strategy

Digital systems are used across the NHS, whether this is inputting information into a computer or organisations running large electronic patient record systems. We are becoming accustomed to working with these technologies, but we are not always aware of risks to safety or how we manage and mitigate against them.

The Digital Clinical Safety Strategy was published in September 2021 setting out two main aims:

  1. To improve the safety of digital technologies in health and care, now and in the future.
  2. To identify, and promote the use of, digital technologies as solutions to patient safety challenges.

The Digital Clinical Safety Strategy helps the health and care system to understand how to develop and use healthcare technologies safely. Digital clinical safety is a key component of the National Patient Safety Strategy and will continue to evolve with the needs of the health and care system, ensuring that patient safety remains central to the digitisation agenda.

Benefits of the Digital Clinical Safety Strategy

It is expected the actions and commitments within the strategy will include work towards the following benefits:

  • Increased reporting and better data quality though the national rollout of the Learn from Patient Safety Events (LFPSE) service and the digital clinical safety training packages. This will support improved safety and reduced number of serious digital clinical safety incidents because of improved system-wide learning.
  • Accelerated adoption of digital technologies to record and track implanted medical devices supported by the sharing of best practice and learning amongst interested communities.
  • Capture safety benefits from major digital transformation programmes led by NHS England including developing key performance indicators related to safety.

Progress so far

A great deal of work has gone on across the system to meet the strategy’s five strategic commitments. The landscape around digital clinical safety has also had an increase in interest as the NHS continues to accelerate the use of digital technology as part of major transformation programmes.

Our Progress against digital clinical safety strategic commitments webpage provides examples of the progress that has been made since the strategy was published in September 2021.

Upcoming priorities in digital clinical safety

Developing safer health technologies and delivering safer care with those technologies is the responsibility of many teams across the health and care system. NHS England priorities for upcoming years are derived from the commitments in the Digital Clinical Safety Strategy, as well as current system needs.

In accordance with the National Patient Safety Strategy, these priorities can be categorised into Insight, Involvement, and Improvement.

Insight

Understanding the trends in digital clinical safety requires greater insight into what happens when things go wrong with health technology and what safety benefits health technologies yield.

We are prioritising the following to support enhanced insights:

  • Capturing greater detail and clarity about digital clinical safety events as part of existing patient safety event recording via LFPSE and encouraging system leaders to promote digital clinical safety event reporting.
  • Creating a feedback loop of digital safety intelligence so that stakeholders across the system are informed about new and emerging digital clinical safety risks.
  • Informing the development of Outcome Registries so they support early detection of safety issues.
  • Evaluating widely used digital health technologies for safety benefits.
  • Measuring digital clinical safety benefits realised through the delivery of major digital transformation programmes including Digitising the Frontline and Digital Primary Care.

Involvement

Building a culture of digital clinical safety starts with training people in the fundamentals and giving people the tools to risk manage digital technologies appropriately. NHS England have been doing this and system leaders have been supporting their staff to undertake training. The next step is to expand this and allow our digital clinical safety leaders to train people across their regions, recognising that many digital clinical safety challenges are unique to certain localities.

We are prioritising the following to support enhanced involvement:

  • Training over 1,000 new NHS staff in digital safety via the Essentials of Digital Safety.
  • Training 200+ new Clinical Safety Officers (CSOs) (dedicated people who lead on digital clinical safety in an organisation) by scaling up the Train The Trainer programme
  • Embedding digital safety within the existing patient safety landscape through networks (i.e., patient safety specialists, medication safety officers and CSOs).
  • Prioritising regional digital leads to advertise training opportunities and disseminate these ideas across digital networks and continuing to increase the visibility of our training opportunities.

Improvement

We aim to ensure continuous improvement around digital clinical safety in the NHS. This includes improving the central resources available for digital clinical safety, such as standards and best practice information, as well as supporting organisations to improve their own digital safety.

We are prioritising the following to support digital safety improvement:

  • Updating and clarifying some of the guidance surrounding the DCB Clinical Safety Standards (DCB0129 and DCB0160). We plan to review and refresh the guidance accompanying the Clinical Safety Standards, with input from patients, professionals, and the public (including regulators)
  • Publish five digital clinical safety best practice blueprints each year on our FutureNHS workspace.
  • Set up a national Scan4Ssafety guidance portal to enable organisations to use digital technologies to improve implanted medical device traceability.

Other key updates

  • The strategy document refers to NHSX, NHS Digital, NHS England and Health Education England. Since April 2023 all these organisations have merged into NHS England. Therefore, any updates will refer to the work of NHS England, and all references to the legacy organisations in the original strategy document should now be considered NHS England.
  • The former NHSX team responsible for the Digital Clinical Safety Strategy has now transitioned to the National Patient Safety Team within NHS England. This provides a clearer alignment with the National Patient Safety Strategy. The former NHS Digital team is now part of NHS England’s Transformation Directorate and are primarily responsible for ensuring the continued safety of NHS England’s digital programmes.
  • While the programme called the Medical Devices Safety Programme (MDSP) was closed in July 2022, work towards better traceability of implanted medical devices has been continued within the Outcomes Registries and Scan4Safety Programmes. This change affects the language in strategic Commitment 4, which previously mentioned MDSP specifically and now has been revised to state, “Accelerate the adoption of digital technologies to record and track implanted medical devices.”