2024 saw the launch of new patient safety initiatives, placing further emphasis on the importance of learning, and the need to hear the patient voice.
Last year also saw the introduction of proposed legislative reform that would bring significant change to the healthcare and medical law landscape: the Mental Health Bill and the Terminally Ill Adults (End of Life) Bill.
Here we consider these key developments and the anticipated next steps in the year ahead.
Martha’s Rule
On 27 May 2024, NHS England announced that 143 hospital sites will be part of the first phase of implementing Martha’s Rule (an automatic right to obtain an urgent review when hospital care is of concern and a patient’s condition is deteriorating).
Martha’s Rule derives from the committed efforts of the parents of Martha Mills after an inquest determined that their daughter would likely have survived had doctors heeded the family’s concerns.
The approach allows early intervention, providing patients, their families and carers to with 24/7 access to rapid review from a critical care outreach team.
Under the first phase, the initiative is to be in place and tested in these locations by March 2025. In collaboration with Martha’s parents, NHS England is developing materials that will explain and raise awareness of the initiative in hospitals.
Patient safety commissioner principles
On 21 October, 2024, the Patient Safety Commissioner for England published a finalised set of Patient Safety Principles, following a public consultation that garnered more than 800 responses.
Established as part of the Commissioner’s statutory responsibilities, the seven Principles serve as a framework for decision-making, planning and fostering collaborative efforts.
The Principles – which include creating a culture of safety, putting patients at the heart of everything and treating people equitably – build on efforts to improve patient safety that have been made over the past 20 years. There has been a move away from a slow, siloed and disjointed approach. A greater emphasis has been placed on learning, and, in particular, a focus on the need to hear the patient voice has become paramount.
The Principles will assist those in governance in healthcare. They will be a guide for those in leadership positions, not only at Board level, but also at all levels within healthcare providers. The Principles are about safe, effective and compassionate patient care, and reducing avoidable harm in a just and learning culture.
Maternity care
Avoiding Brain Injury in Childbirth is a national programme that has been in development in recent years to improve maternity outcomes, and was launched on 7 October, 2024. Central to the programme is supporting maternity services to bring improvements in two particular areas of clinical practice. Namely, monitoring and responding to changes in fetal heart rate and the management of impacted fetal head at caesarean section.
The initiative includes new training methods, and protocols, incorporating learnings from lived experiences. Listening to those receiving and providing maternity care, as well as birth partners, and their families has been key to shaping the programme.
Funded by the Department of Health and Social Care, the programme is a collaboration between the Royal College of Obstetrics and Gynaecologists, Royal College of Midwives and the Healthcare Improvement Studies Institute (at the University of Cambridge).
There are currently nine maternity units at NHS trusts participating in the pilot. Looking ahead, the Department of Health and Social has indicated that if successful, a national roll-out of the programme could follow this year.
Mental Health Bill
Aimed at reforming and modernising the existing Mental Health Act 1983 (the Act), the Bill was introduced in the House of Lords on 6 November, 2024. The Bill advances the majority of the recommendations for reform made in December 2018, following an independent review of the Act.
The Bill is currently at the Committee Stage, where it will undergo detailed review by the Lords, followed by a report stage and third reading before being passed to the House of Commons for further review. The government has indicated that implementation of the reforms will be phased and is anticipated to take several years due to the need for recruitment and training of both clinical and judicial staff.
Terminally Ill Adults (End of Life) Bill
Introduced to Parliament on 16 October, 2024 by way of the Private Members’ Bill ballot, the Bill was published on 11 November, 2024. There is no official government position on the Bill, however, Health Secretary, Wes Streeting has expressed his opposition to the Bill.
The Bill extends to England and Wales only. The proposals set out a model of assisted dying that would enable terminally ill adults who are mentally competent and meet other eligibility criteria to request and lawfully receive the provision of assistance to end their own life.
Among key measures within the Bill are those relating to eligibility requirements (including for the purposes of the legislation when a person will be considered to be terminally ill), initial discussions with registered medical practitioners and procedure, safeguards and protections.
Having undergone a second reading on 29 November, 2024, Members of Parliament will soon start debating principles of the Bill during the Committee Stage in the House of Commons.
