It is estimated that around four million patients admitted to hospital per year in the European Union (EU) suffer from adverse events whilst undergoing healthcare procedures. These events are classified into healthcare-associated infections (approximately 25% of adverse events), medication-related errors, surgical errors, medical device failures, errors in diagnosis and failure to act on the results of tests. Moreover, an estimated 37,000 patients die every year as a result of healthcare-associated infections. Patient safety during treatment is a major concern for the European Commission and the Member States as it constitutes a major public health problem and generates considerable costs.

Back in 2009, the European Commission adopted a ‘Council Recommendation on patient safety, including the prevention and control of healthcare associated infections’. The Recommendation proposed a framework of actions by the EU Member States to improve patient safety and to prevent adverse events which may be contracted in healthcare institutions in four areas: i) policies and programmes on patient safety; ii) the empowering of patients; iii) reporting adverse events and learning from errors, and; iv) education and training of healthcare workers.

Five years after the adoption of the 2009 Recommendation, on June 19 2014, the Commission published the ‘Patient Safety Package’, consisting of: a report on the progress made since the implementation of the Recommendation and on how the Commission and the Member States are currently addressing the challenges of patient safety; the results of a Eurobarometer survey on patient safety and quality of care; and the results of a public consultation on the same topic.

During the launch of the patient safety package, the European Commissioner for Health, Tonio Borg, emphasized that EU citizens have a right to safe healthcare. However, Dr Borg also acknowledged the fact that adverse events are still present in healthcare settings and unfortunately safety is seldom part of the healthcare workers training, therefore creating inconsistency. The pursuit of greater safety must accordingly be considered as an asset in order to fully develop according to the EU criteria.

The Eurobarometer survey was conducted in all the 28 EU countries, including Malta, towards the end of 2013. Various surprising results were noted, including the fact that around 53% of all EU citizens think that patients within the same country are in the possibility of being harmed by hospital care. This result, however, should not reflect negatively on all the Member States. Whilst the percentage was as high as 82% in Cyprus, it was only 21% in Austria. Compared to a similar survey conducted in 2009, the Eurobarometer results show an  increase in patient empowerment which automatically reflects positively on the EU. Such a rise was significantly evident in particular countries such as France (61%) and Spain (40%).

Throughout the Member States, countries where people are most likely to see a lawyer as a source of help, in the case of being harmed by healthcare services, include Germany at 75%, and the Netherlands at 60%. The hospital management is selected most often in Greece and Malta with an approximate 64% for each of these countries.

The public consultation on patient safety and quality of care clearly demonstrated that over 90% of civil society still considers patient safety as an issue within the EU. A major concern was that after a span of five years, this Recommendation has only been partially implemented with many barriers still hindering the full implementation.  Amongst the various identified barriers, one can point out to the limitations of budget and resources due mainly to the economic crisis and also the failure of achieving high levels of awareness.

The report on the implementation of the Recommendation expresses the need for continuous efforts at EU level so as to increase quality care and patient safety, with a proposed list of actions amongst which education and training of healthcare workers is a priority. Other developments include specific guidelines on patient safety standards supported by clear-cut definitions. Greater efforts are also essential in order to ensure specialised infection control staff in healthcare settings.

Kurt Sciberras

Executive - EU Policy and Legislation, MEUSAC