When this issue of Clinical Risk Insights was being planned in the early weeks of 2020, COVID-19 was a distant threat. Since then the threat has been realised and the world of health and social care has been challenged like never before. We are now in the midst of a pandemic that has already extracted an enormous toll in terms of mortality, morbidity and human suffering.

Throughout the COVID-19 pandemic, health and social care workers have been on the frontline, at greater risk of infection, dealing with the emotional and psychological impact of the delivery of care in a crisis situation. As highlighted by the WHO, healthcare workers encounter increased risk of healthcare associated infections, violence, accidents, stigma, illness and death. Furthermore, working in stressful environments exacerbates risks to the physical and mental health and safety of healthcare workers making them more prone to errors which might lead to patient harm.

Health and social care worker safety and patient safety

The interrelationship between health and social care worker safety and patient safety was recently given prominence through the theme for World Patient Safety Day 2020 ‘Health Worker Safety: A Priority for Patient Safety’. The State Claims Agency (SCA) supported this year’s campaign by reminding health and social care services that health and social care worker safety and patient safety go hand in hand and highlighting what can be done to enhance worker safety. With this in mind, it is important that you all continue to be aware of and care for your own wellbeing, and that of your colleagues, so that you can continue to effectively care for others.

Innovation in health and social care delivery

It has been heartening to see the many innovative ways in which health and social care personnel have responded to the crisis.

New models of care and care pathways have been developed and different ways of working and providing care, such as telehealth and remote consultation, have come to the fore. It is to be hoped that innovation, where effective and when it contributes to better and safer care, can be sustained. The pandemic will have far-reaching consequences for health and social care delivery into the future.

As the number of new COVID-19 cases ebbs and flows, the challenge of providing non-COVID-19 care in a world constrained by COVID-19 has emerged. All this brings additional risk, and it is as important now as ever to be guided by the principles of patient safety. Reporting of incidents and adverse events by health and social care enterprises to NIMS, as well as being a statutory requirement, allows for rapid learning at local and national level. In the early stages of the pandemic, the SCA, in consultation with the HSE, updated NIMS to allow for the reporting of incidents related to COVID-19. It also supported, and continues to support, incident reporting in new locations such as testing centres and assessment hubs.

Learning through incident analysis

The SCA’s risk units analyse COVID-19 incidents on a weekly basis and feed back real-time learning to the HSE in order to assist with risk mitigation. This analysis has also informed a number of patient safety and risk advisory notifications issued by the SCA in relation to COVID-19. The SCA’s COVID-19 Indemnity Advices and Risk Advices provide an overview of indemnity and risk advice in relation to the COVID-19 pandemic.

Although COVID-19 has dominated our thinking in recent months, risk unrelated to COVID-19 remains. In addition, many of the factors underpinning clinical risk are common to COVID-19 and non-COVID-19 care. Although the articles presented in this newsletter, do not focus specifically on COVID-19, the learning to be derived from them is just as relevant now as ever.

In this issue, you will find articles on orthopaedic implant incidents, cauda equina syndrome, getting service user identification right and a closed claim case study in which communication came under the spotlight.