LEGAL CORNER: Can the NHS learn lessons from cycling?

Sir Dave Brailsford is famous for turning around the fortunes of British cycling with his “law of marginal gains”.

He saw that small improvements over a whole range of areas could bring about very substantial positive change and, in the case of British cycling, make his teams (GB and Sky) world beaters.

Just as British cycling used to be, the NHS is struggling. Our health secretary has called the rate of avoidable deaths in hospitals “the biggest scandal in healthcare”, and it has been estimated that about 750 patients a month in NHS hospitals have been dying unnecessarily.

This was the conclusion of the largest review of “avoidable deaths”. It is said that one in 28 deaths could be attributed to poor care.

The key word is “avoidable”. Medical error is one of our biggest killers. These mistakes should not happen, but they do, and are often repeated.

Some doctors and staff struggle to admit their mistakes because they worry about reputation and potential litigation. So, they can often “clam up”.

In an innovative approach, the NHS has teamed up with a hospital in Seattle, Virginia Mason Institute, to learn lessons from its culture of transparency, safety and quality.

The Seattle hospital has improved quality and outcomes step by step, across the board, involving all levels of staff in a culture of openness, learning from mistakes and having absolute focus (like Sir Dave Brailsford) on excellence and delivering results.

We can only hope that the NHS quickly learns some lessons. The Seattle hospital has, by virtue of attention to marginal gains, substantially reduced its complaints and clinical negligence claims, and is regarded as a centre of excellence. It has reduced its liability insurance premiums by 74 per cent.

Here in the UK, a debate still rages over whether the so called “compensation culture” has led to fear and poor practice within the NHS i.e. whether those who pursue claims arising from medical negligence are, at least in part, to blame.

The Government certainly appears to think so, with plans to drastically restrict the claims rights of injured victims.

However, this Seattle experience may seem to show the opposite; that an improvement in standards, bit by bit, will vastly reduce the amount of substandard care and resulting claims, and that injury lawyers are almost embraced within the process of shining a light on unacceptable care which will not be tolerated.


By Paul Fretwell

Partner, personal injury department


George Ide, LLP

Solicitors of Chichester and Bognor Regis

Telephone 01243 786668