Professor Robert Galloway – Reducing Medical Errors – Injury Rehab Network

The November Injury Rehab Network with BASRaT featured a presentation from Professor Robert Galloway, Emergency Medicine Consultant at University Hospitals Sussex NHS Trust. The online event took place on the evening of Tuesday, 18th November, with 195 sports rehabilitation practitioners in attendance.

Rob shared insights into human factors in patient care. The recording is available to watch here.

Professor Robert Galloway – Emergency Medicine Consultant, University Hospitals Sussex NHS Trust. MOStJ, MBBS, BSc, MFAEM, MRCP, FRCEM, PGcMedED, MAcMedED

A Consultant in Emergency Medicine and dual trained in Intensive Care, his medical interests centre on improving patient outcomes through changing ‘systems of care’. This includes the use of human factors, developing expertise in risk-taking, designing novel patient pathways, and reforming how we treat colleagues through rostering systems that value staff.

His impact on changing NHS practices resulted in him being made a member of the Order of St John and being named a Top Ten NHS Wild Card Influencer by the Health Service Journal – though, as he joked, he has had very little influence since.

Education is a major passion. He runs human factors and patient safety courses both within and outside UHSussex NHS Trust, and leads undergraduate A&E teaching at BSMS.

He has held several roles outside the NHS, including serving as medical director of the Brighton Marathon for ten years and acting as medical advisor to Brighton & Hove Albion FC. In the media, he writes a fortnightly column for the Daily Mail’s health section and frequently appears on TV and radio to discuss health topics. Under the pseudonym Dr Nick Edwards, he authored the book In Stitches: The Highs and Lows of Life as an A&E Doctor, which has sold over 500,000 copies.

He joked that he once had a social life, hobbies such as mountain walking and even a personality. Now, happily married with five children, he is more likely to be watching Peppa Pig or acting as a taxi service than socialising or climbing mountains.

Reducing medical errors; learning from takeouts and pubs, and not just the pilots

Professor Galloway delivered a powerful and engaging session on reducing medical errors by applying human factors principles drawn from aviation, takeaways, and even pubs. He highlighted that most clinical mistakes are not caused by a lack of knowledge, but by predictable human limitations such as cognitive bias, groupthink, fixation errors, poor communication, and failures in system design.

Using striking examples from emergency medicine, sports medicine, and stadium event medical care, he explained how simple interventions such as checklists, repeat-back communication, structured escalation tools, and clear leadership can significantly improve safety. He demonstrated how diagnostic errors frequently stem from Type 1 thinking, belief bias, and a failure to challenge assumptions critically.

He also explored how clinicians frequently misinterpret test results when they fail to consider the pre-test probability. Throughout the session, he encouraged attendees to slow down, name cognitive biases, use tools such as SBAR and PACE, practise reflective thinking, and foster a culture where anyone can speak up. His personal story involving a preventable death in intensive care, and the loss experienced by both the patient and the clinician, reinforced the importance of human factors in preventing harm.

5 Pillars – Five pillars of care for health professionals were outlined, including technical knowledge, compassion, interpreting evidence, non-technical skills, and resources. He discussed the contrast between what practitioners are taught and what patients need.

What is human factors?

A distinction was made between the definition of human factors and the reality in practice. Human factors were described as a set of behavioural and cognitive skills that go beyond technical competence, essentially, how to think and behave at work.

The danger of groupthink was highlighted, along with the importance of checking and reporting back. Checklists (as used by pilots, pubs, and takeouts) are vital in ensuring consistent care.

He described levels of defence against errors using the Swiss cheese model, where poor design, procedures or management decisions may lead to active errors or patient safety incidents. Care can be improved through human factors by:

• Understanding and improving how we make decisions
• Improving how we implement treatments
• Changing the culture to allow the above to happen

Decision Making

Decision making, the role of professionals as ‘diagnosticians’, and attitudes to risk were discussed. To make a diagnosis, health professionals must consider the patient’s medical history and understand the tests and their results. The two systems of thinking (fast/intuitive and slow/rational) should both be utilised.

A series of problems was presented to illustrate how tests are often misinterpreted. Cognitive biases may lead the brain to jump ahead, missing important details or information. Type 1 thinking is particularly susceptible to these limitations. While our brains are capable of unconscious competence (such as driving effortlessly), this can also introduce bias.

He outlined strategies for managing cognitive bias, based on slowing down, reflecting, and challenging decision-making. Patient care and safety can be improved through a sterile cockpit, specific “acute” leadership skills, effective communication, checklists, civility skills, and patient involvement.

The bystander effect and groupthink were also examined, along with the reasons why individuals may fail to respond appropriately in emergencies.

Acronyms useful in decision-making included:

• SBAR = Situation, Background, Assessment, Recommendation
• PACE = Probe, Alert, Challenge, Emergency

Culture Change

The importance of civility was emphasised, including the significant impact of simply being polite. One study showed anaesthetists performed around 30% better with a polite surgeon compared to a rude one.

He outlined challenges associated with healthcare culture, where experienced leaders can sometimes resist innovation and forward-thinking practices. An example was Semmelweis, a pioneer of antiseptic policy whose peers initially rejected his methods.

He summarised that human factors are about “being a knob” — encouraging individuals to be more questioning and challenging.

Further information and follow Professor Robert Galloway

Human Factors in Healthcare book – Rob’s book about human factors is coming out in March 2026 and can be preordered – pre-order via Amazon

Human Factors Courses

Professor Galloway runs two types of courses.

One is at the hospitals in Sussex every month. All the dates are on Eventbrite here: Events UHSx Events – 15 Upcoming Activities and Tickets | Eventbrite

It is £195 per person and has 6 hours of CPD. It is organised through the hospital, but external candidates are welcome to attend.

Rob can also deliver a course at your place of work. Please email Rob at drrobgalloway@gmail.com for details. Please see the course flyer for details.

Rare People Charity

Rob also spoke about belief bias. That tendency we all have to make a diagnosis because it fits with what we wish it to be. It happened to Rob with his daughter. He delayed recognising her developmental delay and delayed seeking help. When Rob finally did get help, the diagnosis was of a very rare genetic condition. And this is what led him to establish a research charity focused on rare neurodevelopmental conditions. In the past, these conditions could never be treated. However, with AI now identifying repurposed drugs, there is real potential. The problem is that, because the drugs already exist and the conditions are so rare, there is no funding available for pharmaceutical companies to conduct the research. That is why we set up the charity.

For more information on the charity or getting involved, please see the Rare People charity website

To donate or to have rare people the research charity as your charity partner for a sponsored event, please visit https://www.justgiving.com/charity/rarepeopletheresearchcharity

If your organisation would like to be a charity partner or have any sporting memorabilia that they could auction to raise funds please email rarepeoplecharity@gmail.com

One thing to note about the charity is that 100 per cent of all donations go directly to research. Rob’s medical company, which runs the Human Factors courses, covers all the charity’s costs. So everything people donate goes straight into research.

Follow Professor Rob Galloway on X

Q&A

Rob kindly answered questions put forward by practitioners who attended the session. Please see the presentation recording for the insights from Rob to the questions.

Presentation Recording

The recording of Rob’s presentation is available to watch here.

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