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\begin{document}

\title{How often do doctors report serious clinical incidents? A comparison to
other healthcare workers and the experience of clinical incident
reporting in the NHS.}



\author[1]{Habib Rahman}%
\author[2]{Nicki Cornford}%
\affil[1]{Affiliation not available}%
\affil[2]{Eastbourne District General Hospital}%


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  \date{May 24, 2024}


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\begin{abstract}
Rationale, aims and objectives: Clinical incident reports are the
primary means by which UK hospitals are alerted to avoidable harm in
healthcare. However, data demonstrating the patterns in real-world
reporting by healthcare workers have never been published in the UK.
Though this journal has previously published survey data describing the
discrepancies between respondents' own behaviour compared to the
incidence of perceived avoidable harm, we set out to collect data on
actual reporting patterns between healthcare workers. Given the concerns
raised by Robert Francis following the Mid-Staffordshire Inquiry, we
specifically wished to examine the rate of reporting of doctors compared
to other healthcare workers. Methods: We selected for incidents causing
at least `moderate' levels of harm, theorising that such levels of harm
are most likely to be noticed by doctors. Data from 2011 to 2019 from
the clinical governance departments of 2 NHS hospitals was requested and
all available data subsequently charted. Results: This is the first
study examining NHS incident reporting patterns in the medical
profession. We demonstrated a stark level of underreporting of clinical
incidents causing harm ranging from `moderate' to death by doctors. This
was particularly dramatic at the non-consultant grade level. In 1
hospital, only 2 deaths were reported by non-consultant grade doctors in
6 years. Notably 1 hospital had not stored any incident reporting data
until 2017. Conclusion: The reporting behaviour of doctors has not
significantly changed despite the Francis Reports. This could be
improved by creating incentives for doctors to engage with patient
safety initiatives and disclosure of error, as well as the use of
automated systems.%
\end{abstract}%



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