Technology

The Cumberlege Review and Scan4Safety two years on – what we know now

At the beginning of 2020, just weeks before the Covid-19 pandemic changed the world, Baroness Julia Cumberlege went on a visit she described as “a revelation”. At University Hospitals of Derby and Burton NHS Foundation Trust, she witnessed the organisation’s Scan4Safety programme firsthand, discovering how every item used on a patient was scanned and recorded before use. Baroness Cumberlege was then in the process of conducting her two-year review into the use of Primodos, sodium valproate and pelvic mesh

Primodos, a hormonal pregnancy test withdrawn from the market in 1978, was thought to be associated with birth defects and miscarriages. Epilepsy drug Sodium Valproate could be harmful if taken during pregnancy, potentially causing abnormalities to the baby. Pelvic mesh implants, used to treat prolapse and incontinence in women, could cause agonizing chronic pain described by sufferers as feeling “like razors inside the body”.

Due to a lack of data on the use of these products, it was difficult to measure the untold harm caused to many thousands of women and children across the UK, or get an accurate picture of how the health service had responded to learn from past mistakes.

The significance of accurate data

The lack of data is the very reason why the visit to University Hospitals of Derby and Burton NHS Foundation Trust had such an impact. Derby’s Scan4Safety programme meant the trust was able to accurately identify every product used, every patient it was used on, and every location of where a medical intervention had occurred. The premise of the Scan4Safety programme involves the use of GS1 Identification Keys to uniquely identify all people, products, and places throughout the healthcare supply chain and patient pathway. All aspects are identified using the same set of data standards, allowing information to be shared between systems and organisations when needed.

In the context of Baroness Cumberlege’s review, the benefits become evident. Had a national system been in place whereby these products could have been identified and traced directly to the individual

patient, it is likely that trends in the reporting of adverse events could have been noted earlier, protecting thousands of patients from unnecessary harm.

Acknowledging the many benefits, Baroness Cumberlege commented, referring to her time visiting Derby, “[it] brought home to me the power of data.”

Two years on, how far have we come?

July 2022 marked two years since the publication of Baroness Cumberlege’s final review and the release of the Scan4Safety evidence report– but two years on, has anything changed?

Nine recommendations were referenced in Baroness Cumberlege’s review and strides are continually being made to bring these to fruition.

Progress that has been made so far: last month, Dr Henrietta Hughes was appointed as the UK’s first Patient Safety Commissioner; the Healthcare Safety Investigation Branch (HSIB) has begun the transition into the Health Services Safety Investigations Body (HSSIB) – a non-departmental public body of the Department of Health and Social Care in England; the Medicines and Healthcare products Regulatory Agency (MHRA) have made initial provisions for UK medical device legislation to promote greater transparency and safety; and Plans were initiated for the development of a national patient-identifiable database.

Measures are now being taken to prevent large scale patient safety incidents from occurring, protecting millions from avoidable clinical errors and unnecessary harm.

However, transparency and traceability are required if these recommendations to drive meaningful change are to have an impact. These rely on two key pillars: globally unique identification and the widespread adoption of standardised data.

Results from the Scan4Safety programme clearly illustrate how GS1 standards have the power to drive traceability and improve patient safety.

Since the publication of the report, variations of the Scan4Safety programme have been established in Scotland, Wales and Northern Ireland; demonstrating an increased focus on improving product traceability across UK health systems.

A place for Scan4Safety in the future of healthcare

During the opening keynote at the 2022 GS1 UK Healthcare Conference, Baroness Cumberlege emphasised the crucial importance of traceability in clinical settings and reiterated the message of the way in which point of care barcode scanning can drive patient safety.

GS1 standards power traceability in healthcare by uniquely identifying every person, every product, and every place throughout the supply chain and patient pathway.

Crucially, by using Global Trade Item Numbers (GTINs) to unambiguously identify medical devices, and Global Service Relation Numbers (GSRNs) to link that data to the patients each device is used to treat, medicines and devices can be effectively monitored and rapidly recalled from market circulation if any problems or issues occur.

“I’m determined to ensure we use data, that we harness technology and we improve systems to create safer, better, more informed and more caring healthcare.” Baroness Julia Cumberlege

The Scan4Safety program continues to save thousands of lives and millions of pounds in NHS trusts across England, simply by harnessing the power of universal, open data standards.

As Baroness Julia Cumberlege said during her opening keynote speech: “Data can do remarkable things.” All healthcare stakeholders now need to work collectively to capitalise on its potential to protect and make care safer for all. L

FURTHER INFORMATION

www.gs1uk.org/industries/healthcare healthcare@gs1uk.org

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Meeting the numbers

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Don’t forget the efficacy audits too!

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Keeping it simple

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