Medicine recognised its safety problem very late: the first irrefutable evidence that around 10% of hospital patients were harmed by their care only appeared in the 1990s. Strategies for improvement have drawn on “human factors” systems analysis and on civil aviation, and the NHS has introduced ways to identify and analyse safety incidents, yet the overall rate of patient harm has not demonstrably fallen. Professor McCulloch discussed why patient safety is such a “wicked” problem, the obstacles that change faces in hospitals, and what radical improvement would require.
Speaker
Peter McCulloch is Professor of Surgical Science and Practice at the University of Oxford. He qualified in medicine at Aberdeen University and trained in surgery in Glasgow before becoming a consultant in Liverpool in 1992. A specialist in gastrointestinal cancer surgery, since moving to Oxford in 2005 his research has focused on the IDEAL Collaboration, which works to improve the scientific evaluation of surgery and other complex treatments, and the QRSTU research group, which develops and trials interventions to improve the safety of surgery.
Report: read the write-up of this lecture, The conundrum of patient safety improvements: why is it so hard?, from Newsletter 42 (December 2025).