A new checklist is to be introduced in all British hospitals with the aim of reducing errors during surgery. The Safer Surgery Checklist was launched yesterday, and is designed to reinforce the verification of basic precautions prior to, during and after surgical procedures.

Developed by a World Health Organisation committee, chaired by health minister Lord Darzi and led by US surgeon and writer Atul Gawande, the tool draws lessons from the airline industry. A series of highly basic checks, including the area of the body to be operated on and a count of the number of surgical swabs and needles, is carried out before the procedure starts and after it finishes.

The WHO reports that in preliminary trials on 1,000 hospital patients worldwide, use of the checklist raised adherence to defined standards of safety and care from around 36% to 68%.

In the UK, over eight million operations are undertaken every year. The national Patient Safety Agency, which is responsible for co-ordinating reports of what are termed ‘adverse incidents’, suggested that last year there were 129,000 reported incidents. Those who have researched this area generally agree that patient safety incidents are considerably under-reported.

Estimates suggest that errors in surgery kill around 2,000 NHS patients every year. In 2005, a National Audit Office report suggested that half of all patient safety incidents could have been avoided if the lessons from previous incidents had been properly and systematically learned.

Biggest innovation since the stethescope?
Mr Gawande said in a statement: “The complexity of medicine has increased to the point where no one person can ensure that it is delivered reliably and accurately. The checklist is turning out to be as important to successful care as the stethescope”.

The prescribing and administering of drugs is of course another area where patient safety can easily be compromised. As well as dosage errors, there have been many cases where drugs are given via the wrong route. The chemotherapy drug vincristine, which should be given intravenously, has been given as a spinal injection, which is usually fatal. In 2001, an incident of this kind caused the death of 18-year-old Wayne Jowett in Nottingham. The Government subsequently promised to reduce to zero the number of people killed in this type of incident.