title: Which clinical errors lead to the referral of UK paediatricians to the National Clinical Assessment Service?
abstract: The aim of this study was to determine which clinical errors lead to the referral of UK paediatricians to the National Clinical Assessment Service (NCAS). Data for the 10-year period from 1 April 2001 to 31 March 2011 were analysed. Referrals are classified into clinical, behavioural and health related. Clinical referrals can be general, relating to general deficiencies in knowledge and skills, or specific and concerned with a critical incident. Specific clinical referrals were analysed. There were 259 paediatric cases in this period. There were 110 (42 %) clinical concerns in the 259 cases. In 47 of the 110 cases, these were general concerns. There were 63 cases where specific clinical concerns had led to the referral. These were: diagnosis and management of child protection cases, 19; prescribing errors, 13; diagnosis other than child protection cases, 12; treatment incidents, 7; difficulties with transfer of a patient to another unit, 6; poor resuscitation, 4; and slow response to an emergency, 2. In 16 of the cases, the patient died.
  
  
  CONCLUSIONS
  This analysis reveals some different errors to those in other studies of paediatric litigation and complaints. Mistakes in child protection cases were the commonest reason for referral to NCAS. Prescribing errors were the second commonest cause. Difficulties in the diagnosis and treatment of a range of different conditions accounted for the next biggest group of referrals. This study helps highlight areas of paediatrics, such as child protection and prescribing, where training needs to be improved in order to improve patient safety.
authors.affiliation: Whittington Hospital, Magdala Avenue, London, N19 5NF, UK. joseph.raine@nhs.net
authors.forename: Joseph
authors.initials: J
authors.lastname: Raine
authors.forename: Diana
authors.initials: D
authors.lastname: Scarrott
mesh_terms: D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data; D002983:Clinical Competence / Q000706:statistics & numerical data*; D006801:Humans; D019300:Medical Errors / Q000145:classification / Q000706:statistics & numerical data*; D061214:Patient Safety; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data*; D006113:United Kingdom