Dr. Roger Evans, FRCP, FRCS
Honorary Consultant in Emergency Medicine

It is an unfortunate fact that over the last couple of decades claims for alleged medical negligence have risen dramatically in the UK.

The reasons behind the increase are several and include, amongst other causes, an increasingly litigious society, a trend which will certainly not go into reverse.

The cost of meeting these claims is a major drain on finite health service resources and takes money which could, and indeed should, be spent on patient care.

There have been attempts to tackle the problem and Emergency Medicine in the UK, the BAEM and Faculty have been in the forefront, with other Royal Colleges, running educational events to define and publicise the problem and consider solutions.

Unfortunately the pressure on doctors in Emergency Medicine continues to increase due to the ever rising demand in this speciality and urgent effective action is necessary to stem the continuing drain on health service resources.

Some years ago, whilst at a major emergency medicine conference in the United States, I met Dr. Dan Sullivan who has huge experience of the situation with regard to medical negligence claims in Emergency Medicine in the US.

Subsequently he formed a Health Care Risk Management Company, The Sullivan Group (TSG) which has developed a new approach to reducing medical errors and the inevitable litigation that follows.

The TSG programme has had what could only be termed a dramatic success in reducing both errors and the consequent legal actions which have often resulted in expensive settlements, in the U.S.

The programme has been introduced in several large hospital groups and has been a major success in all of them, in the United States.

One group, HCA Inc., which runs some 200 hospitals, has been able to reduce claims against it by over 40% in a three year period (from 2002 – 2005); a result which would have a major positive impact if repeated in this country.

The group is now bringing the programme to the UK, and having had the opportunity of reviewing it with some of my colleagues locally, I believe it can be deployed in the whole of Great Britain with equal success.

With its web based, standardised risk and safety educational component; lessons related to risk and safety built into medical records, and its powerful web based performance evaluation component, the group has created a tool that should have a powerful, positive impact on how we practise Emergency Medicine.

This programme is a proven successful instrument to aid all of those working in Emergency Medicine and, I believe, should create a safer environment for patients and doctors in the UK.

We not only need to ensure that our patients are cared for in the safest possible environment, but we need to protect the medical and nursing staff working in our departments. It is my opinion that there is nothing which is more stressful than learning that one is to be sued for a medical accident; especially an accident that might have been avoided with proper training and appropriate documentation.