NHS patients still experience medical mistakes, inefficiency and poor communication from doctors, according to a survey carried out by the Commonwealth Fund.

The UK has a better record on medical mistakes than the US, Australia, New Zealand and Canada, but 20 per cent of those surveyed reported that they had been the victim of a medication or other medical error in the last two years.

A spokesman for the Department of Health said: "Ensuring the safety of everyone that comes into contact with health services is one of the most important challenges facing health care today, not just here but worldwide.

"In this country, the Department of Health's has set a clear agenda to ensure the safety of NHS care and to learn from adverse events - a programme established by Professor Sir Liam Donaldson, chief medical officer, and a key part of the NHS Plan, the government's 10 year modernisation agenda for the NHS.

"The National Patient Safety Agency (NPSA), established in 2001, has a key role in implementing our agenda to ensure the safety of NHS care and to learn from adverse events.

"The agency has already begun collecting and analysing key information from local organisations and from other sources - providing relevant and timely feedback to organisations and clinicians to help them improve patient safety.

"Following on from piloting of this system in 28 hospitals and primary care units, the reporting and learning system is undergoing further testing and development in early 2003 prior to being implemented across the NHS from later in 2003. Over time, the agency will give us a real handle on the scale of the problem - a baseline allowing us to understand the real extent and nature of adverse events, and the ability to act on that knowledge.

"The Department of Health welcomes any form of patient feedback. The NHS has a comprehensive patient survey programme administered by the Commission for Health Improvement.

"The NHS is moving to a system of electronic patient records (EPR). Every patient will have an EPR by 2005.This will ensure the availability of the patient's record at the appointment with the health professional.

"The new structures for patient and public involvement in health are intended to ensure improved relationships and communication with patients and the public. Communication skills and customer care training are also in place for NHS staff.

"National Service Frameworks set standards and define service models to ensure safe, high quality, co-ordinated care. National Institute of Clinical Excellence publishes guidance on the clinical and cost effectiveness of treatments. These are intended to minimise the degree of conflicting information patients receive."

Forum Response: BUPA

A spokeswoman for BUPA told ePolitix.com: "Quality of care is as important to the independent sector as it is to the NHS. Independent sector companies need to provide high standards of care; otherwise their customers will exercise choice and go elsewhere for treatment.

"The Health and Social Care Bill 2003 contains provisions that will create a single regulatory framework for the NHS and independent sector. BUPA broadly supports these proposals because a single body, regulating both sectors to the same standards, will improve patient care and increase transparency.

"Successful patient communication relies on the ready availability of health information. This enables patients to make informed decisions about their health and care in partnership with their doctor.

"The public often find thorough and accurate health information hard to locate. This is why BUPA has, amongst other things, produced 'The BUPA ABC of Health' - a series of seventy fact sheets exploring a wide variety of health issues."

Forum Response: Royal National Institute of the Blind

Dan Vale, UK Campaigns Manager for the Royal National Institute of the Blind told ePolitix.com: "Our research confirms the results of this survey. Nearly two million people with a sight problem need clear and accessible information. It is an outrage that medical and pharmaceutical information is not routinely available in Braille, large print or on tape. Hundreds of thousands of blind people are at constant risk of taking the wrong dosage or missing vital appointments because they may not be able to read a label or letter.

"We know of distressing instances when blind people have had to rely on neighbours to read letters disclosing private and proprietary information such as smear test results. RNIB calls on all health providers to make communication and information far more accessible."

Forum Response: Nursing and Midwifery Council

A spokesman for the Nursing and Midwifery Council told ePolitix.com: "It is important to recognise that mistakes will happen whatever the health care system. As the regulator, we receive many complaints about nurses who are alleged to have made a mistake.

"If it's a one-off mistake, we are reluctant to pursue the matter as this serves no purpose. The way to avoid mistakes as far as possible is to have effective systems of supervision and support for staff rather than wait for something to go wrong and then embark on a witch hunt."

Forum Response: Insulin Dependent Diabetes Trust

Jenny Hirst, co-chairman of the Insulin Dependent Diabetes Trust, told ePolitix.com: "Many people with diabetes report to us that their hospital doctors do not listen to the problems that concern them most.

"This applies especially to their reports of suspected adverse reactions to synthetic insulins when all too often they feel that they, the patients, are blamed rather than the insulin. This can lead to a lack of trust and a breakdown in communication between doctor and patient."

Forum Response: General Medical Council

A spokesman for the GMC told ePolitix.com: "The General Medical Council sets standards for doctors both during their medical education and throughout their working career.

"We believe that it is essential for a doctor to communicate well with patients and other healthcare professionals to ensure that individuals have a clear understanding of their treatment and the options available to them. Our guidance on this subject covers topics such as listening to patients, giving information and explaining issues and, where necessary, apologising for mistakes.

"The GMC is currently preparing the introduction of revalidation for all doctors. Revalidation is the process whereby a doctor's right to practise will be affirmed by assessing them against our standards every five years. In many cases, this system will run alongside the annual NHS appraisal."