BMA press releases archive

New ways of working need improved communication, BMA and NPSA say

(issued Friday 06 Aug 2004)

New hospital working patterns mean that improved communication between doctors is essential to protect patients, the BMA Junior Doctors Committee and the NHS National Patient Safety Agency say today (Friday 6 August).

‘Safe handover: safe patients’ provides guidance to doctors, managers, and other NHS staff on communicating information at the end of a shift. It warns that poor handover can lead to errors that threaten patient safety.

The guidance is timely because of the European Working Time Directive, which has caused hospitals to move away from on-call patterns to shift systems which increase the numbers of individuals caring for patients. Different teams will be looking after the same groups of patients over the course of a 24 hour period.

It is essential that this move away from personal continuity results in system continuity, the guidance states, and it suggests mechanisms to support the transfer of clinical information between team members.

These include:
  • Protected, bleep-free, time for team-members to meet and share information
  • Access to up-to-date management plans for each patient
  • Effective means of identifying and contacting the doctor who is responsible for a patient at any given time
  • Password-protected patient lists on the hospital intranet
  • Allowing doctors to carry patient information on wireless enabled handheld computers – this would also allow test results to be automatically sent to he right doctor

The guidance also states
  • Senior clinicians should supervise handover, and be involved in the process on a daily basis
  • Handover should be at a fixed time and of sufficient length
  • Shifts for all staff involved in handover should be co-ordinated so they can attend meetings

In an accompanying message to the guidance, Mr Simon Eccles, chairman of the BMA Junior Doctors Committee, says:

“We all hand over information about patients every working day. Many of us would accept that our present mechanisms for doing so are far from ideal. A scrap of paper left with a rushed phone call represents a real risk to our patients’ quality of care. This document sets out to change that. We will become increasingly reliant on high quality information to be able to look after our patients and it is imperative that the systems in place. In turn, this will allow us to offer our patients even better care and improve the quality of our working lives. Talking to fellow junior doctors in hospitals with really excellent handover arrangements in place, they all state that they cannot now imagine working in a system without them.”

The NPSA Medical Director, Professor Sir John Lilleyman says: “Handover of care is one of the most perilous procedures in medicine, and when carried out improperly can be a major contributory factor to subsequent error and harm to patients. This has always been so, but its importance is escalating with the requirement for shorter hours for doctors and an increase in shift patterns of working.”


Note to editors

Click here to view full guidance:



Nick Rigg
Communications Directorate
National Patient Safety Agency
4-8 Maple Street
London W1T 5HD
Tel: 020 7927 9362
Fax: 020 7927 9501

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