Care Quality Commission. The state of health care and adult social care in England 2021/22. 2022a. (accessed 2 November 2022)

Care Quality Commission. Adult inpatient survey 2021. 2022b. (accessed 2 November 2022)

Reading the signals. Maternity and neonatal services in East Kent – the Report of the Independent Investigation. 2022. (accessed 2 November 2022)

The report of the Morecambe Bay Investigation. 2015. (accessed 2 November 2022)

Healthcare Safety Investigation Branch. National learning report. Never events: analysis of HSIB's national investigations. 2021. (accessed 2 November 2022)

NHS Resolution. Duty of candour animation. 2022. (accessed 2 November 2022)

Moving beyond the rhetoric in NHS patient safety: facing up to failings

10 November 2022
Volume 31 · Issue 20


John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent reports on NHS patient safety

In any field of professional endeavour there comes a time when members and profession leaders need to pause and reflect on what they do and take stock.

To ask, where are we, what are we doing and where are we going? Is what we are doing still worthwhile? Are we effective and still fulfilling our purpose? Or, most worryingly, have we met our ‘Waterloo moment’? Are we meeting our ultimate obstacles and being roundly defeated by them?

Some recently published NHS patient safety reports have raised all these questions in my mind when thinking about the current states of NHS patient safety.

The first report to cause me to pose these questions is the long-awaited report by Dr Bill Kirkup (Kirkup, 2022) into the events at the maternity and neonatal services in East Kent. This has just been published and it makes for dire reading. This is compounded when the report is also read alongside Kirkup's previous report into events at Morecambe Bay (Kirkup, 2015). Even though these reports concern maternity care, they have important implications for nurses and doctors in other care areas.

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