Surgical Fires in the NHS

Debate between Christina Rees and Wes Streeting

Thursday 16th December 2021 Westminster Hall

[Wes Streeting (Ilford North) (Lab)]

It is a pleasure to see you in the Chair, Ms Rees. I apologise on behalf of the shadow Minister for patient safety, my hon. Friend the Member for Nottingham North (Alex Norris), who is isolating, so I am afraid that you are stuck with me, the shadow Secretary of State for Health, which at least gives me the opportunity early on to place on the record my commitment to patient safety.

I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate and on underlining—in terms of the policy detail and what the data tells us or does not tell us, as well as in very stark human terms—why this issue is so significant. As he said, I have no doubt that there would have been more hon. Members present for this debate if it were not for the omicron risk and the fact that this is the final afternoon before the House adjourns for Christmas.

Surgical fires are a serious patient safety issue. In the contributions we have heard today—from the hon. Member for Strangford and the spokesperson for the Scottish National party, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar)—the case for further action to prevent these incidents is clear.

Although rare, surgical fires can cause serious harm to both patients and healthcare professionals, and, as we have heard, in some cases they tragically result in life-changing injuries. The Department for Health and Social Care has declared that it does not know how many surgical fires happen across the NHS, because it does not collect such data centrally, but we know that they happen. In the period between 2010 and 2018, there were a total of 96 recorded surgical fire incidents declared by NHS England acute trusts and Welsh health boards. A search of the NHS’s National Reporting and Learning System for the period between January 2012 and December 2018 identified 37 reports of surgical fires. There is a discrepancy between those two figures. In my opinion, even one preventable incident of surgical fire in the NHS is one too many.

Although surgical fires are preventable, the absence of national guidelines has resulted in an inconsistent approach within UK hospitals to their prevention, with fewer than 40% of healthcare organisations in England having specific protocols and training programmes in place to address the prevention and management of surgical fires. Among healthcare organisations across the UK, 50% of healthcare organisations in Northern Ireland have specific surgical fire prevention guidelines, compared with 38% in England, 20% in Wales and 10% in Scotland, and only a limited number of trusts across the UK—23—have protocols and training programmes that specifically address surgical fires.

We know that these incidents occur as a result of particular circumstances, yet the majority of local trusts rely on general fire safety guidelines, in which there is often no mention of surgical fire risks and prevention processes for them.

The hon. Members who have spoken in this debate have discussed the findings of the expert working group’s report, which was published last year, so there is no need for me to go over the report’s recommendations; we have already heard them. However, it would be good to hear from the Minister this afternoon as to whether she has had the chance to consider those recommendations and understands where the Department intends to go in taking action to respond to them.

As the hon. Member for Strangford said in his opening speech, the report also supported surgical fires becoming classified as a never event. The NHS in England defines never events as

“serious incidents that are entirely preventable because guidance or safety recommendations providing strong systemic protective barriers are available at a national level and should have been implemented by all healthcare providers.”

Patient groups have argued that surgical fires should be classified as never events. They argue that if they were classified in this way, they could be monitored and investigated as such. Staff would also be empowered to manage incidents in the appropriate way.

However, the Government have recently said that they have no plans to revise the NHS never events policy and framework to classify surgical fires in operating theatres as never events. As the hon. Member for Strangford pointed out, the reason for that is that we currently have no national guidance or safety recommendations to prevent surgical fires in operating theatres. I endorse what he said. I think that the way to address that is to ensure that we have national guidance and safety recommendations and then to update the NHS never events policy. It would be good to hear from the Minister what progress, if any, has been made in developing that guidance and, if the Government intend to act in that way, when it might be published.

I would also like briefly to address some wider issues related to patient safety that are relevant to the debate. Unfortunately, in the last financial year prior to the pandemic 472 serious patient safety issues were classified as never events across the NHS in England. Clearly, that figure demonstrates that there is work to be done across the NHS to ensure everyone gets the best care and that improvements still need to be made. In striving for that, we of course need to listen carefully to the experiences of the patients affected and to ensure that staff feel safe to come forward during patient safety investigations and that processes are transparent, so that lessons can be learned.

We also need to do more to ensure that the environments in which care is delivered are safe. Currently, there is a £9.2 billion repair backlog across the NHS estate. That means that broken pipes and crumbling buildings are putting patients at risk. In the past financial year there were more than 1,600 serious patient safety incidents with an estates and facilities cause.

Although I am responding on behalf of the Opposition, I am sure the House and the Minister will indulge in me making a parochial constituency point. Whipps Cross hospital is in urgent need of redevelopment and refurbishment, and I think that is very much on the Government’s radar—I am led to believe that Whipps Cross is near the top of the list. The Minister may not be able to reply on Whipps Cross this afternoon—I appreciate that it is probably without the scope of what she was expecting to talk about—but the issue is none the less on the record for the Department to consider, and we will be very persistent about it on a cross-party basis locally.

Chronic workforce shortages across our health and care services are also putting patients at risk. We went into the pandemic with 100,000 vacancies across the NHS, including a shortage of 40,000 nurses. I am struck whenever I speak to staff working in the NHS, including the shadow Minister for mental health, my hon. Friend the Member for Tooting (Dr Allin-Khan), who has enormous experience in this respect, that too often staff are coming home from work worried about staffing shortages, patient safety and whether they have been able to deliver the best care. That is really important for patient safety and the confidence of staff working in challenging environments. In June, a report by the Health and Social Care Committee warned that staff burnout caused by workforce shortages was at an emergency level and posed

“an extraordinarily dangerous risk to the future functioning of”

healthcare services.

Last month, NHS leaders warned that pressures on the system were likely to have an impact on patient safety, and a survey revealed that nine out of 10 felt that staffing pressures were putting patients’ health at risk. It is clear that the NHS is now in desperate need of a serious plan to provide the modern, safe facilities and equipment that patients deserve, alongside a long-term strategy to recruit and retain the staff to deliver safe, quality care. The safety of patients must be the golden thread running through every aspect of healthcare delivery, and I want our healthcare system to be the safest in the world. I hope that the Minister will consider the points raised in the debate carefully and assure the Members present that the prevention of patient safety incidents, including surgical fires, is of paramount importance to her Department.

Since this is the last day before we rise for the recess, and in the light of the wider challenges facing the country, I wish you, Ms Rees, and all hon. Members and staff throughout both Houses of Parliament a very merry Christmas. I say a special thank you to Ministers and staff at the Department of Health and Social Care, the agencies for which they are responsible, the entire workforce across health and social care, the armed forces and the emergency services for all that they are doing to get our country through the pandemic, to respond to the challenges of the omicron variant and to get Britain boosted. I ought to wrap up, because I am due to get my booster later this afternoon, and I do not wish to miss my appointment. I look forward to hearing what the Minister says, and I wish her and all her civil servants and colleagues in the Department of Health and Social Care a very merry Christmas and a happy new year.

[Christina Rees (in the Chair)]

I echo everything the hon. Gentleman said in wishing everyone a merry Christmas and thanking them for everything they do.