Patient safety 5 – The impact of healthcare inequality on patient safety

RCPCH Podcasts

Health inequalities are widening in paediatrics. Those that are more disadvantaged experience more safety issues whilst in health care. If we can make our healthcare systems more equitable for the children and young people we can for, they will be safer in our care.

In episode 5 of our series on paediatric patient safety, we speak with Dr Helen Stewart, Dr Cian Wade and Dr Mimi Malhotra to explore how patient safety and health inequalities are inextricably linked. Tackling healthcare inequalities can improve safety and vice versa.

Dr Stewart shares her knowledge and experience as the RCPCH Officer for Health Improvement as to how our children are impacted by health inequalities. Dr Wade and Dr Malhotra discuss their BMJ paper, Action on patient safety can reduce health inequalities, and explore some of the improvement avenues that are available to clinicians and service providers.

Thank you for listening.

Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber, RCPCH Head of Quality Improvement | Produced by 18Sixty

Please be advised that this podcast series contains stories relating to child death and harm. All views, thoughts and opinions expressed belong to the guests and not necessarily to their employer, linked organisations or RCPCH.

Download transcript (PDF)

About the Patient Safety series

As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings.

We hope you will be entertained, educated and energised to make strides in improving the safety of the children that you care for.

The RCPCH Patient Safety Portal has lots of resources, including a wealth of learning about paediatric patient safety. The RCPCH health inequalities programme of work can be found on our key topics pages.

It is imperative to turn this knowledge into action through improvement activities.

About the speakers

• Dr Helen Stewart is a Consultant in Paediatric Emergency Medicine at Sheffield Children’s Hospital. She also has an interest in public health and health inequalities, which has led to her becoming the Officer for Health Improvement at RCPCH.
• Dr Cian Wade completed a National Medical Director Clinical Fellowship with NHS England. He is a Fulbright Scholar who recently completed a Master of Public Health at Harvard University and now consults for health systems and healthcare providers.
• Dr Mimi Malhotra completed a National Medical Director Clinical Fellowship with the Health Foundation. Dr Malhotra continues to work as a respiratory trainee in London with ab honorary clinical lectureship at UCL.

Topics/organisations/papers referenced in this episode

• Wade, C, Malhotra, A.M., et al (2022). Action of patient safety can reduce health inequalities. BMJ
• North West & North Wales critical care transport service
• Michael Marmot
• Royal College of Emergency Medicine (RCEM)
• RCPCH Health Improvement Committee
• National Medical Directors Fellowship
• The Health Foundation
• RCPCH Child health inequalities driven by child poverty in the UK - position statement
• Increased risk of perioperative pulmonary embolism and sepsis in black patients (Urban Institute)
• Increase risk of adverse drug events in black people (Medical Care)
• MBRRACE study: A comparison of the care of Asian, Black and White women who have experienced a stillbirth or neonatal death
• Racial and ethnic differences in bystander CPR for witnessed cardiac arrest (The New England Journal of Medicine)
• Skin Deep
• WHAM (Wellbeing and Health Action Movement) health inequalities map
• Race-based vs race-conscious model of medicine (The Lancet)
• Decentralisation of public services in Greater Manchester (PDF)
• Sugar tax explained
• Vaping in children (RCPCH response to Government plan to ban disposable vapes)
• Health and Social Care Committee - a Commons Select Committee
• Core20PLUS5 – An approach to reducing health inequalities for children and young people
• Nationwide Children's Hospital (US)
• Shared decision making framework (NICE)
• Closed feedback loop communication
• Ian Sinha: The cost of the clinic visit (European Respiratory Journal)
• RCPCH Engaging children and young people resources
• RCPCH Six step toolkit for child health inequalities and poverty
• WHAM (Wellbeing and Health Action Movement) portal
• Institute for Healthcare Improvement
• Natural language processing (Wikipedia)