The Weston Report was recently published by the South West Strategic Health Authority.  It is a detailed critique of a review undertaken by the United Kingdom British Orthopaedic Association (BOA).  As a result of the BOA’s significantly flawed review, the Welsh Assembly Government recalled 683 patients who had undergone orthopaedic surgery at the Weston National Health Service Treatment Centre on a precautionary basis because of concerns over patient safety.

The report discusses amongst other issues the way in which unconscious cognitive biases can affect those undertaking clinical and patient safety reviews to the detriment of the investigation.

The report’s author, Professor Brian Toft OBE, says: “I have tried to produce the report in such a way that healthcare professionals can learn from the events that have occurred and I thought it would be of interest to the CHFG – particularly as the first item on the latest newsletter is about learning from errors.”

He continues: “I am very happy for my report to be shared on the CHFG website.  Because if the BOA’s Reviewers had not been unconsciously influenced by the human factors that were identified during the review then it is highly likely that many of the errors would not have been made.”

Read the full report here.