'Harm free' care

The NHS Safety Thermometer is a local improvement tool for measuring, monitoring and analysing patient harms and 'harm free' care. The areas measured were selected because they are common, and clinical consensus exists that they are largely preventable through appropriate patient care. All indicators based on safety reporting need to be treated with caution, as reporting rates can vary between sites and over time. In some senses a higher level of incident reporting may be a good indicator of a more positive attitude towards safety issues.

How have rates of inpatient pressure ulcers changed?

Pressure ulcers (sometimes known as "bedsores" or "pressure sores") are a type of injury that breaks down the skin and underlying tissue. They are caused when an area of skin is placed under pressure. Pressure ulcers tend to affect people with conditions that make it difficult to move, especially those confined to lying in a bed or sitting for prolonged periods of time. Conditions that affect the flow of blood through the body, such as type 2 diabetes, can also make a person more vulnerable to pressure ulcers.

Pressure ulcers have been used as a marker of good basic nursing care for some time. The severity of ulcers is recorded using a scale from 1 to 5 – where 5 are the most serious.

In acute settings, incidence of type 2, 3 and 4 pressure ulcers decreased from 5.6% of sampled patients in April 2012 to a low of 3.8% in September 2015, but this has fluctuated since.

How have rates of pressure ulcers in the community changed?

Incidence of pressure ulcers in community settings decreased from 8.8% of sampled patients in April 2012 to 4.5% of patients in November 2014. Since then, incidence has remained around 5%.This is still slightly here than in the acute setting, but the gap has narrowed considerably.

How have rates of inpatient VTE changed?

A venous thrombosis is a blood clot that forms within a vein. A classical venous thrombosis is deep vein thrombosis (DVT), which can break off (embolize), and become a life-threatening pulmonary embolism (PE). The disease process is therefore called venous thromboembolism (abbreviated as VTE). However, the risk of developing DVT is increased in certain circumstances experienced and seen in care settings such as inactivity, damaged blood vessels, certain medical conditions and associated interventions. In acute setting, incidence of venous thromboembolism (VTE) decreased from 1.5% of sampled patients in April 2012 to 0.5% of patients in December 2014. The proportion of patients with VTE has increased slightly, but remained broadly stable between 0.5% and 0.6%.

How have rates of community VTE changed?

Incidence of VTEs are higher in acute settings, with an average of 0.9% of all sampled patients having a VTE recorded in the time period, compared to 0.3% in a community setting. Incidence of VTEs in a community setting decreased from 0.5% of sampled patients in September 2012 and has been declining since.

About this data

Developed for the NHS by the NHS, the Safety Thermometer is a point of care method for surveying patient harms and analysing results to measure and monitor improvement and harm free care over time.

From July 2012, data collected using the NHS Safety Thermometer is part of the Commissioning for Quality and Innovation (QUINN) payment programme. This incentivises the collection of data on patient harm using the NHS Safety Thermometer to survey all relevant patients in all relevant NHS providers in England one day each month.

One year's worth of data is available so more rigorous time series analysis is only possible with future data releases.


I am unsure what data is being presented here. The charts say 'incidence' of pressure ulcers, VTE and yet the data source is from the NHS Safety Thermometer which does not report incidence data but prevelance data.

Rebecca Broughton (not verified)
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Thank you for your enquiry. The data being presented in the charts is the proportion of sampled patients recorded with the presence of one of the above harms (in this case VTEs or category 2, 3, or 4 pressure ulcers) on the day of the survey within the organisation submitting data to the Safety Thermometer.

QualityWatch Team (not verified)
(changed )

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