The information requested is provided in the following table:

* Note 2014 data are incomplete

The table illustrates the number of incidents reported to the National Reporting and Learning System where the incident report contained keywords indicating multiple pregnancies, from 1 January 2005 to 30 September 2014, by degree of harm reported as caused by the incident. It is important to note that the inclusion of these keywords may not always indicate the incident directly affected a multiple pregnancy; for example, reference in the incident report may be made to previous pregnancies. The harm reported may relate to the mother or to one or more foetuses/infants.

The overall number of patient safety incidents reported to the National Reporting and Learning System has increased every year since its inception. Increasing numbers of reported patient safety incidents are considered to be a sign of an improving patient safety culture and increases in the number of incident reports should not be interpreted as deterioration in the safety of patients.

The Friends and Family Test (FFT) was implemented as a mechanism to provide near real-time feedback to identify both good and poor quality patient experience. Whilst the FFT aims to capture overall patient experience, part of the experience that patients may choose to comment on is whether they felt their care was safe. This information can then be used by providers to consider what they do well and make improvements where feedback is less positive. Commissioners and regulators monitor the results of the FFT and the Care Quality Commission (CQC) uses the data - together with other data such as mortality rates and ‘never events’ - as part of its new ‘Hospital Intelligence Monitoring’. The monitoring service gives the CQC an understanding of areas of care that need to be further investigated by inspectors:

http://www.cqc.org.uk/public/hospital-intelligent-monitoring

In April 2014, the Staff FFT was introduced to allow staff feedback on NHS Services based on recent experience. The Staff FFT asks staff to rate and comment on where they work as a place to work and as a place of care. This information can then be used by employers to consider what they do well and make improvements where feedback is less positive.

Commissioners and regulators also monitor the results of the Staff FFT, and the CQC uses this data as part of their Intelligent Monitoring system. The response to this question is also displayed as a key patient safety indicator on NHS Choices:

http://www.nhs.uk/NHSEngland/thenhs/patient-safety/Pages/patient-safety-indicators.aspx

In addition, hospital boards and other providers and commissioners of services can consider the results of the FFT to consider the implications for quality and safety. A NHS England review of the FFT found that it is performing well as a service improvement tool, with 85% of trusts reporting that it is being used to improve patient experience, and 78% saying that FFT has increased the emphasis placed on patient experience in their trusts.

The Government has put in place a number of measures to support National Health Service orgnisations to respond positively to the Berwick Report ‘Improving the Safety of Patients in England’’ including greater transparency, openness and candour; ensuring safe staffing levels; creating a culture of learning and development with the establishment of 15 Patient Safety Collaboratives; and making patient safety a primary goal with a new ambition to halve avoidable harm and save 6,000 lives over the next three years, underpinned by the Sign up to Safety campaign.

As at 28 November 2014, 91 trusts were recorded as poor (red) against the open and honest reporting indicator. Data prior to June 2014 is not available in this form.

The Health and Social Care Information Centre (HSCIC) has provided data on (a) a count of finished admission episodes (FAEs) where there was a primary diagnosis of pulmonary embolism and the number of FAEs as a rate per 100,000 of the total number of FAEs and (b) a count of finished consultant episodes (FCEs) with a primary or secondary diagnosis of pulmonary embolism and the number of FCEs as a rate per 100,000 of the total number FCEs, for the years 2000-01 to 2012-13.

This is summarised in the following table:

Public Health England (PHE) collects data on blood stream infections caused by bacteria (bacteraemia) relating to specific organisms as part of its mandatory Healthcare Associated Infection surveillance programmes.

Microbiology laboratories in England, Wales and Northern Ireland also voluntarily submit data to PHE relating to episodes of bacteraemia and blood stream infections caused by fungi (fungaemia).

The data summarised in Tables 1-3, taken from PHE’s mandatory surveillance programmes, represent bacteraemia cases reported in England resulting from: Methicillin-resistant Staphylococcus aureus (MRSA); Methicillin-susceptible Staphylococcus aureus (MSSA) and E.coli where comparable data is available. Rates of all reported cases per 100,000 population are included, where available.

Note: Data is available at: https://www.gov.uk/government/statistics/mrsa-bacteraemia-annual-data

Note: Data is available at: https://www.gov.uk/government/statistics/mssa-bacteraemia-annual-data

Note: Data is available at: https://www.gov.uk/government/statistics/escherichia-coli-e-coli-bacteraemia-annual-data

The data summarised in Table 4, taken from PHE’s voluntary surveillance database, represents all voluntarily reported patient episodes involving either bacteraemia and/or fungaemia for the period of January 2008 to December 2012 in England, Wales and Northern Ireland.

Note: Data extracted from the Public Health England (PHE) voluntary surveillance database, LabBase2, on 3 December 2013.

Before 2009, information was not collated on foreign bodies retained after procedures (which is classed as a ‘never event’) and so we are unable to provide data for the period prior to 2009.

In 2009-10, there were nine retained foreign objects post procedure reported during this period.

In 2010-11, there were 67 retained foreign object never events reported to Strategic Executive Information System (STEIS) and 22 reported to the National Reporting and Learning Service (NRLS).

In 2011-12, there were 161 retained foreign object never events reported to STEIS and 86 reported to the NRLS in 2011-12.

In 2012-13, there were 130 retained foreign object never events reported to STEIS and 124 reported to the NRLS in 2012-13 (please note incidents are potentially reported to both systems but the exact degree of overlap of reported incidents during the period 2010-11 and 2011-12 is unclear).

Since April 2013 reports made to the NRLS and STEIS have been directly reconciled to provide a single total and provisional data published by NHS England shows 123 retained object never events were reported in 2013-14 and 44 in the six months to September 2014:

http://www.england.nhs.uk/ourwork/patientsafety/never-events/ne-data/

Methods for identifying and collating the data from two systems (NRLS and STEIS) have changed over the years, with specific reporting fields for Never events replacing keyword searches, and year-end attempts to reconcile events reported in both systems replaced with direct communication as and when incidents were reported. This is a further reason why events from the earlier years are not directly comparable. The numbers of Never Events reported for 2010-11 and 2011-12 were reported in Annex A of the ‘The never events policy framework: An update to the never events policy’

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213046/never-events-policy-framework-update-to-policy.pdf

It should be noted that the updated policy expanded the list of never events from 8 to 25 in 2012 and the detail of definitions of retained foreign objects was also clarified in The never events list; 2013/14 update:

http://www.england.nhs.uk/wp-content/uploads/2013/12/nev-ev-list-1314-clar.pdf.

Note numbers in different years are not directly comparable due to these definitional changes.

The Department commissioned Frontier Economics to investigate the costs of unsafe care in the National Health Service. The final report, Exploring the cost of unsafe care in the NHS suggests that the costs of preventable, adverse events is likely to be more than £1 billion per year, but could be up to £2.5 billion annually. The report, which was published on 16 October, is available at:

http://www.frontier-economics.com/publications/exploring-the-costs-of-unsafe-care-in-the-nhs/

The Sign up to Safety campaign launched in June is now working with healthcare organisations to make the NHS one of the safest healthcare systems in the world and contribute to the goal to halve avoidable harm and save 6,000 lives over the next three years.

It is difficult to disaggregate direct cash releasing savings from this evidence which must take into account the upfront costs of investing in safer care.

Do Ministers agree that the patient transport guidance should be interpreted with an understanding of rural needs, rather than telling my elderly constituents to report to a hospital 60 miles away and to get three buses there and three back that do not connect with each other in order to have treatment or consultation?

The Sign up to Safety campaign was launched on 24 June 2014. Each organisation that has joined the campaign has committed to improving patient safety through the implementation of a Safety Improvement Plan. The Safety Improvement Plan builds on the pledges the organisation set out when joining. The pledges are expanded in more detail in the plan, which sets out what the organisation wants to achieve and by when. Each organisation is expected to demonstrate how they will measure the local impact of their aims over the next three years via a measurement section within their plans. They will then implement their aims over the next three years.

The Sign up to Safety campaign is being promoted by means of:

- a national campaign website;

- regional and national presentations at events across the country delivered by the Campaign Director, the Secretary of State and others;

- Twitter with over 1,500 followers;

- a blog by the Campaign Director;

- an online seminar programme (webinars);

- through partner organisations including NHS England, Care Quality Commission, Monitor, NHS Trust Development Authority, NHS Litigation Authority, Health Education England, and NHS Improving Quality;

- mini poster campaigns, such as the Safe Care Costs Less, and individual events, such as the launch of the Patient Briefing Video; and

- through participant websites and local events.

As at the end of October 2014, a total number of 136 organisations have agreed to participate in the Sign up to Safety campaign. Each participant organisation is expected to set out how they will contribute to the campaign’s three year objective via their Safety Improvement Plan – they are expected to quantify the expected impact of their actions on a reduction of avoidable harm and saving lives. The measurement and evaluation of the impact at a regional and national level will be led by NHS England working with NHS Improving Quality as part of the integrated measurement strategy for both the campaign and the Patient Safety Collaborative programme. This will include the National Reporting and Learning System, harms via the Safety Thermometer and mortality rates, case studies of individual organisations and patient record reviews.

The Sign up to Safety campaign was launched on 24 June 2014. Each organisation that has joined the campaign has committed to improving patient safety through the implementation of a Safety Improvement Plan. The Safety Improvement Plan builds on the pledges the organisation set out when joining. The pledges are expanded in more detail in the plan, which sets out what the organisation wants to achieve and by when. Each organisation is expected to demonstrate how they will measure the local impact of their aims over the next three years via a measurement section within their plans. They will then implement their aims over the next three years.

The Sign up to Safety campaign is being promoted by means of:

- a national campaign website;

- regional and national presentations at events across the country delivered by the Campaign Director, the Secretary of State and others;

- Twitter with over 1,500 followers;

- a blog by the Campaign Director;

- an online seminar programme (webinars);

- through partner organisations including NHS England, Care Quality Commission, Monitor, NHS Trust Development Authority, NHS Litigation Authority, Health Education England, and NHS Improving Quality;

- mini poster campaigns, such as the Safe Care Costs Less, and individual events, such as the launch of the Patient Briefing Video; and

- through participant websites and local events.

As at the end of October 2014, a total number of 136 organisations have agreed to participate in the Sign up to Safety campaign. Each participant organisation is expected to set out how they will contribute to the campaign’s three year objective via their Safety Improvement Plan – they are expected to quantify the expected impact of their actions on a reduction of avoidable harm and saving lives. The measurement and evaluation of the impact at a regional and national level will be led by NHS England working with NHS Improving Quality as part of the integrated measurement strategy for both the campaign and the Patient Safety Collaborative programme. This will include the National Reporting and Learning System, harms via the Safety Thermometer and mortality rates, case studies of individual organisations and patient record reviews.

The Sign up to Safety campaign was launched on 24 June 2014. Each organisation that has joined the campaign has committed to improving patient safety through the implementation of a Safety Improvement Plan. The Safety Improvement Plan builds on the pledges the organisation set out when joining. The pledges are expanded in more detail in the plan, which sets out what the organisation wants to achieve and by when. Each organisation is expected to demonstrate how they will measure the local impact of their aims over the next three years via a measurement section within their plans. They will then implement their aims over the next three years.

The Sign up to Safety campaign is being promoted by means of:

- a national campaign website;

- regional and national presentations at events across the country delivered by the Campaign Director, the Secretary of State and others;

- Twitter with over 1,500 followers;

- a blog by the Campaign Director;

- an online seminar programme (webinars);

- through partner organisations including NHS England, Care Quality Commission, Monitor, NHS Trust Development Authority, NHS Litigation Authority, Health Education England, and NHS Improving Quality;

- mini poster campaigns, such as the Safe Care Costs Less, and individual events, such as the launch of the Patient Briefing Video; and

- through participant websites and local events.

As at the end of October 2014, a total number of 136 organisations have agreed to participate in the Sign up to Safety campaign. Each participant organisation is expected to set out how they will contribute to the campaign’s three year objective via their Safety Improvement Plan – they are expected to quantify the expected impact of their actions on a reduction of avoidable harm and saving lives. The measurement and evaluation of the impact at a regional and national level will be led by NHS England working with NHS Improving Quality as part of the integrated measurement strategy for both the campaign and the Patient Safety Collaborative programme. This will include the National Reporting and Learning System, harms via the Safety Thermometer and mortality rates, case studies of individual organisations and patient record reviews.

As at the end of October 2014, a total number of 136 organisations have agreed to participate in the Sign up to Safety campaign. A breakdown by Academic Health Science Network (AHSN) is as follows:

The information has not been split by clinical commissioning group. However 16 clinical commissioning groups have signed up to the campaign to date.

Patient safety alerts are a crucial part of NHS England’s work to alert the healthcare system rapidly to risks and provide guidance on preventing potential incidents that may lead to harm or death. They are publications providing urgent information to healthcare providers via the Central Alerting System. Prior to the establishment of NHS England, patient safety alerts were issued by the National Patient Safety Agency (NPSA).

We do not record the number of patient safety alerts issued by month; however, a list of alerts with their issue dates for the period 2013-2014 is attached.

A full list of alerts issued by NPSA from 2002-2012 can be viewed at:

http://www.nrls.npsa.nhs.uk/alerts/

We do not hold information on the number of patient safety incidents that have occurred in England in each year since 2000. Patient Safety Incidents occurring in the National Health Service are reported to the National Reporting and Learning System (NRLS) whose primary purpose is to enable learning from patient safety incidents. The NRLS was established in late 2003 as a largely voluntary scheme for reporting patient safety incidents, and therefore it does not provide the definitive number of patient safety incidents occurring in the NHS. However, from 1 April 2010 it became mandatory for all providers registered with the Care Quality Commission (including all NHS trusts and foundation trusts) in England to report all serious patient safety incidents to the Care Quality Commission. To avoid duplication of reporting, providers of NHS services are encouraged to report all incidents resulting in death or severe harm to the NRLS which then reports them to the Care Quality Commission.

At present, more than 100,000 patient safety incidents (including those resulting in no harm) are reported to the NRLS each month. However, these data are collated on a quarterly, rather than monthly basis. Detailed breakdowns on incidents reported are published twice-yearly and can be accessed via the following link:

http://www.nrls.npsa.nhs.uk/resources/collections/quarterly-data-summaries/

The most recent spreadsheet providing quarterly data for the number of patient safety incidents reported to the NRLS from October 2003 to June 2014 is attached.

The NRLS is a dynamic reporting system, and the number of incidents recorded as occurring at any point in time may increase as a greater proportion of incidents are reported. Experience in other industries has shown that as an organisation’s reporting culture matures, staff become more likely to report incidents.

We do not hold information on the number of patient safety incidents that have occurred in England in each year since 2000. Patient Safety Incidents occurring in the National Health Service are reported to the National Reporting and Learning System (NRLS) whose primary purpose is to enable learning from patient safety incidents. The NRLS was established in late 2003 as a largely voluntary scheme for reporting patient safety incidents, and therefore it does not provide the definitive number of patient safety incidents occurring in the NHS. However, from 1 April 2010 it became mandatory for all providers registered with the Care Quality Commission (including all NHS trusts and foundation trusts) in England to report all serious patient safety incidents to the Care Quality Commission. To avoid duplication of reporting, providers of NHS services are encouraged to report all incidents resulting in death or severe harm to the NRLS which then reports them to the Care Quality Commission.

At present, more than 100,000 patient safety incidents (including those resulting in no harm) are reported to the NRLS each month. However, these data are collated on a quarterly, rather than monthly basis. Detailed breakdowns on incidents reported are published twice-yearly and can be accessed via the following link:

http://www.nrls.npsa.nhs.uk/resources/collections/quarterly-data-summaries/

The most recent spreadsheet providing quarterly data for the number of patient safety incidents reported to the NRLS from October 2003 to June 2014 is attached.

The NRLS is a dynamic reporting system, and the number of incidents recorded as occurring at any point in time may increase as a greater proportion of incidents are reported. Experience in other industries has shown that as an organisation’s reporting culture matures, staff become more likely to report incidents.

The information requested is not collected centrally.

The survey was sent to 2.63 million patients. There was a 34% response rate to the survey, with 903,357 surveys being returned.

The latest GP Patient Survey (GPPS) results were published on 3 July 2014 and can be found on the GPPS website:

https://gp-patient.co.uk/

The data included in the July publication was collected in two waves during July to September 2013 and January to March 2014.

The information requested is not held centrally by the Department.

The information requested is held by the General Medical Council, an independent body responsible for dealing firmly and fairly with doctors whose fitness to practise is in doubt.

There are robust arrangements in place to maintain patient safety in the dispensing of prescription medicines through medicines legislation, national health service pharmaceutical services regulations and professional regulation. These arrangements are kept under review and changes made as necessary.