The SafeCare Country Director of PharmAccess, Bonifacia Benefo Agyei, has called for a stronger patient-safety framework for people living with non-communicable diseases (NCDs), anchored on quality standards, outcome-based care, digital continuity and sustainable facility financing.

She said the safety of patients with chronic conditions could not be determined by a single consultation or medical procedure, but by the cumulative quality of care they received throughout their treatment journey.

Speaking at an event organised by the Ghana Health Service in Accra to commemorate World Patient Safety Day, Mrs Benefo Agyei said the health sector must measure its success by whether patients were demonstrably safer and receiving better outcomes a year after interventions had been introduced.

She illustrated the challenge with the case of a woman diagnosed with hypertension in her forties who could expect to live with the condition for another 30 or 40 years.

Such a patient, she said, could encounter hundreds of healthcare professionals, prescriptions and referrals during her lifetime, while often having to rely on her memory to provide her medical history because her records or medical information might not move seamlessly between facilities.

“The safety of such a woman is not in a single event, but the sum of every consultation, every prescription, every hand-off,” she said.

According to the World Health Organisation (WHO), one in every 10 patients is harmed while receiving healthcare globally, with about half of the harm considered preventable.

NCDs, including hypertension, diabetes, cancer and heart disease, account for about 74 per cent of deaths globally and more than four in every 10 deaths in Ghana, she said.

4 interventions

Mrs Benefo Agyei said PharmAccess, through its SafeCare programme, was using four complementary interventions to address critical points at which care for NCD patients could break down.

The interventions focus on quality standards, value-based care, digital continuity and access to finance for healthcare facilities.

Through SafeCare, PharmAccess supports health facilities to assess their services against internationally recognised standards, identify weaknesses and translate the findings into measurable quality improvements.

She said the programme worked with the Ghana Health Service, the Christian Health Association of Ghana (CHAG) and private healthcare providers to ensure that quality improvement became embedded in Ghanaian institutions and was sustained by Ghanaian health teams.

“Quality care is owned by Ghanaian institutions and practised by Ghanaian teams, not imported and not temporary,” she said.

Globally, she said, SafeCare had assessed thousands of health facilities, with 74 per cent demonstrating measurable improvement in quality.

Systems supported through the methodology now serve approximately 9.6 million patient visits every month, she added.

Paying for better outcomes

Mrs Benefo Agyei said PharmAccess was also supporting Ghana’s movement towards value-based healthcare, under which healthcare providers are rewarded for the outcomes achieved by patients rather than simply the number of procedures performed.

Working with the National Health Insurance Authority (NHIA) and CHAG, PharmAccess is evaluating the approach for hypertension and diabetes.

The assessment, she said, would consider clinical outcomes, quality of life, patient experience and financial protection together rather than treating each measure separately.

She said the approach could help shift the focus of healthcare delivery from the volume of services provided to whether those services actually improved patients’ health.

Digital continuity of care

Another intervention is NkwaPlus, a digital health platform developed in partnership with technology company Afrifanom and currently being piloted with selected health facilities and patient groups.

Mrs Benefo Agyei said the platform was designed to address the gap between consultations by allowing patients to share health information from home with their healthcare teams.

This could enable providers to monitor patients continuously and respond to emerging risks before they developed into emergencies.

She said continuity was particularly important for people living with chronic diseases, whose health could change between scheduled consultations.

Financing quality improvements

Mrs Benefo Agyei said the fourth intervention was access to financing through the Medical Credit Fund, which provides loans and technical assistance to healthcare providers to enable them to implement quality improvement priorities.

She said an assessment that identified a patient-safety risk would have limited value if a health facility lacked the resources to address the problem.

The Medical Credit Fund has so far supported more than 2,100 healthcare providers and disbursed more than 12,000 loans, with a repayment rate of 95 per cent.

About 30 per cent of its lending supports women-led healthcare enterprises, she said.

According to Mrs Benefo Agyei, the four interventions were designed to work together rather than independently.

“Standards identify the problem, financing fixes it, digital tools catch it early, and payment reform rewards the outcome,” she said.

“It is the combination that makes patients safer.”

4 conditions for safer care

Mrs Benefo Agyei identified four conditions she said were necessary to make patient safety and quality healthcare a daily reality: visible leadership, sustained investment, meaningful measurement and patients as partners.

She said patient safety must be treated as a standing priority at every level of the health system, from the Ministry of Health to individual hospital wards.

“Patient safety must be a standing item at every level, from the Ministry to the ward,” she said.

She also called for stronger financial and human-resource commitments to quality improvement.

“Commitment must be visible in budgets, in staffing, in operational plans,” she said.

She further stressed that assessments, peer reviews, incident reports and patient feedback would only be useful if they resulted in concrete action.

“Assessments, peer reviews, incident reports and patient feedback matter only when each one ends in a named person, a date, and a change,” she said, adding that health workers must also be able to report harm without fear.

The fourth condition, she said, was to empower patients, particularly those living with chronic conditions, to understand their conditions and participate actively in decisions about their care.

Action before next commemoration

Mrs Benefo Agyei urged stakeholders to leave the commemoration with a clearly defined set of actions, each assigned to a responsible person or institution and backed by a timeline, budget and measurable indicator of success.

She proposed that by the next World Patient Safety Day commemoration, the health sector should be able to demonstrate which actions had been funded, which had been implemented and, most importantly, how those actions had made patients safer.

On behalf of PharmAccess and its Country Director, Dr Maxwell Antwi, she reaffirmed the organisation’s readiness to provide technical support and help mobilise resources with partners to strengthen patient safety and quality of care.

“The strongest expression of our commitment will not be spoken here today,” she said. “It will be what changes in our facilities tomorrow.”