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Keep up to date with the latest news, research and activity in patient safety.

High repeat surgery rates under review at five trusts

At least five trusts are reviewing their rates of repeat breast cancer surgery after recording levels significantly above the maximum expected level, HSJ has learned.
Their high rates were identified in this year’s National Cancer Audit, published last month.
While these can be caused by multiple and complex factors – and there is no suggestion at this stage of avoidable patient harm – the metric is a significant patient safety marker.
For example, it was a factor in triggering the high-profile breast cancer care investigation which uncovered significant patient harm at County Durham and Darlington Foundation Trust. A review of up to 4,500 cases continues.
HSJ contacted trusts which recorded rates more than 5 per cent above the maximum level expected by NATCAN auditors.
Airedale Foundation Trust, Buckinghamshire Health FT, Royal Berkshire FT, Blackpool Teaching Hospitals FT and Torbay and South Devon FT all recorded rates that were more than 5% above the maximum level expected by National Cancer Audit Collaborating Centre (NATCAN) auditors, who examined the period between January 2021 and December 2023.
Read full story (paywalled)
Source: HSJ, 7 October 2026
Patient Safety Learning

UK Government backs recommendations of NHS doctors-led AI Commission

The UK Government has confirmed it will accept all 44 recommendations made by the National Commission into the Regulation of AI in Healthcare, published 10 September, and has set out how they will be delivered across the UK. Alongside the response, the Medicines and Healthcare products Regulatory Agency (MHRA) is opening the call for applications for the third phase of AI Airlock, its regulatory sandbox for AI-enabled medical devices, with testing themes directly informed by the Commission’s recommendations.  
The Commission concluded that the current regulatory approach must evolve for AI technologies by designing a more proportionate, lifecycle-based framework. 
The Government's response commits the UK to developing a world-leading agile approach to AI device regulation that supports innovation while maintaining patient safety and public trust. The reforms aim to ensure patients can benefit from safe, effective and trusted AI more quickly, while maintaining robust safeguards as technologies evolve. 
Among the first steps set out in today’s response, the MHRA is also committed to issue draft guidance by December 2026 on a new approach to managing changes to AI-enabled medical devices as they adapt and improve over time, moving towards a regulatory system that is designed to maintain safety while supporting timely access to innovative devices. The MHRA will also begin next year by consulting on how to qualify and classify AI-enabled devices, the first recommendation of the National Commission.  
Other commitments include exploring new staged authorisation pathways, allowing promising AI tools to be used in the NHS earlier under close supervision while further real-world evidence is gathered. A full implementation roadmap, setting out timelines and responsibilities across all 44 recommendations, will be published by Spring 2027, with regular progress updates to follow. 
Read full article.
Source: MHRA, 6 October 2026
Related Reading
Patient safety and the regulation of AI in healthcare (Patient Safety Learning)
Reflections on the National Commission into the Regulation of AI in Healthcare recommendations (Clive Flashman)
Mark Hughes

‘Organisational shame’ driving defensive behaviour at inquiry trust

Staff at a trust subject to a statutory inquiry are paralysed by fear, a review has discovered.
Essex Partnership University Foundation Trust is under scrutiny by the Lampard Inquiry, which is examining the deaths of over 2,000 services users in the organisation’s care. It began in 2023 and is expected to report by 2028.
An external review of how the trust is coping has been undertaken by the King’s Fund and charity brap.
This has revealed the impact of the Lampard Inquiry, service pressure, and financial constraints on senior managers, middle managers, and frontline staff.
Read full article (paywalled).
Source: Health Service Journal, 6 October 2026
Mark Hughes

UK Government joins forces with Breast Cancer Now

Women across the country will be better supported to spot the signs of breast cancer and know where to turn for help as the UK Government announces its first partnership to help deliver its renewed Women’s Health Strategy. 
Marking Breast Cancer Awareness Month, the Department of Health and Social Care will partner with the UK’s largest breast cancer charity, Breast Cancer Now, over the next 3 years, giving women practical information to build confidence in checking their breasts, recognising changes, and seeking advice sooner - particularly in underserved areas.
It comes as new research from Breast Cancer Now reveals almost a third (29%) of women in England who regularly check their breasts do not feel confident to notice a change, while just over one in 10 (11%) of those checking less than once a month say it’s because they do not know what to look out for.  
One in 5 (20%) UK adults also say they are not confident they would know where to find trusted information about breast cancer if they had concerns.  
Women will also be provided with better support after their treatment, including clear information to understand the possible signs of breast cancer returning or spreading and how to live a healthy lifestyle post breast cancer treatment.  
Healthcare professionals will receive additional training, alongside a practical toolkit for healthcare teams, so they can provide the best possible advice to women adapting post-treatment. 
Read full article.
Source: Department of Health and Social Care, 5 October 2026
Mark Hughes

Women suffer more pain than men across the whole body, major global study finds

Women report suffering more pain than men, a major new global study has found.
That was true for all types of pain the researchers measured, and comes amid continuing concern about the gender pain gap, which means women are less likely to be prescribed the pain relief they need.
Researchers from all over the world carried out “one of the largest harmonisation efforts in pain epidemiology to date”. Data was collected from more than 6 million people from 118 countries from 1990 to 2025, and included people from aged five years to more than 100.
The research, published in Nature Medicine, looked at how pain, as the leading global cause of disability, was distributed both around the world and across the human lifespan.
It found women’s self-reported pain across 11 bodily sites – head, face, neck or shoulder, foot or ankle, hand or wrist, elbow, chest, back, stomach or abdomen, hip and knee – was higher than for men.
Read full article.
Source: The Guardian, 5 October 2026
Mark Hughes

Ten NHS trusts referred over monitoring consent

Ten mental health trusts have been reported to the health regulator after problems with patient consent procedures when monitoring patients using camera technology.
The issue emerged during the latest hearings of the Lampard Inquiry, which is examining the deaths of more than 2,000 people who spent time in mental health units in Essex between 2000 and the end of 2023.
The infrared technology is used in patients' bedrooms and can monitor breathing and pulse without staff having to enter the room.
NHS England told the inquiry it had passed information to the Care Quality Commission (CQC) after reviewing the use of digital monitoring systems, including Oxevision.
Read full article.
Source: BBC News, 6 October 2026
Mark Hughes

RFK Jr. says AI can ‘free us from medical tyranny’ and is ‘better informed’ than doctors

US Health Secretary Robert F. Kennedy Jr. last week told attendees at the Make America Healthy Again Summit that artificial intelligence could help address key health issues and can offer a “better-informed” second opinion than doctors, as the prominent vaccine sceptic once again railed against public health experts and COVID-era response strategies.
Speaking to Vice President JD Vance in a “fireside chat” to close out the MAHA summit, Kennedy argued AI offers the capacity to solve the “most daunting public health problems that are otherwise existential.”
Touting AI’s ability to digest thousands-page-long medical records, Kennedy claimed it can give you “a second opinion that is much better informed than any doctor in the country.”
Kennedy said another change he expects AI to bring is that health policymaking will never again be dominated by public officials “who tell us ‘Trust the experts.’”
Kennedy said every American will be able to check their own medical advice and argued that AI had the capacity to “free us from medical tyranny.”
“If somebody tells you, ‘Masks work, trust the experts,’ A.I. may tell you otherwise. If somebody tells you, ‘Social distancing works, trust the experts,’ A.I. may correct that. And if somebody tells you that a vaccine will prevent transmission and infection, or you need to take it to protect your grandmother, A.I. may say it actually doesn’t do that,” Kennedy said.
Read full story
Source: Forbes, 1 October 2026
Patient Safety Learning

Government alert sounded over EPR cyber security risk

The  “concentration” of electronic patient record systems under a relatively small number of suppliers has increased the risk of highly damaging cyber attack, a government review has concluded.
The Department of Health and Social Care’s Gateway review of NHS England’s Frontline Productivity programme reported “EPRs and their hosting/supplier dependencies present concentration and cyber risks”, and this “may warrant” their designation as “critical national infrastructure”.
The review, which has been seen by HSJ, says responsibility for the cyber risks posed by EPR concentration was “fragmented” and that there was “material uncertainty” over how an attack might be prevented and responded to. 
The gateway review said it was “essential” that NHSE “publish minimum cyber security requirements for EPRs and clarify cyber risk ownership”.
Read full story (paywalled)
Source: HSJ, 5 October 2026
Patient Safety Learning

Early Lampard findings could come within weeks

The chair of a public inquiry into mental health deaths said she would make interim recommendations if she identified issues that "might pose an urgent risk to patient safety".
Baroness Kate Lampard is examining the deaths of more than 2,000 people who died while under the care of Essex mental health services between 2000 and the end of 2023.
The Lampard Inquiry will hear further evidence during hearings beginning on 5 October before deciding whether recommendations were needed ahead of a final report, Baroness Lampard said.
Any recommendations were expected to focus on inpatient safety, including resuscitation procedures and monitoring technology used to detect patients in distress.
"Those two matters are not specific to Essex and therefore the evidence the inquiry hears will be of relevance to service providers across the entire country," Baroness Lampard said.
"It may carry implications for the care and treatment provided on all mental health units."
One system under examination as part of the inquiry is Oxevision, which can take footage, record breathing and pulse rates and is used by a number of NHS mental health trusts in England.
Concerns have been raised about privacy, dignity and whether the technology could be used as a substitute for face-to-face care.
Tammy Smith, whose daughter Sophie Alderman died in 2022, previously told the inquiry: "It actually takes away human interaction. They are at their most vulnerable.
"They need those conversations. They need someone to ask, 'Are you OK? Do you need anything?' We all need that."
Read full story
Source: BBC News, 5 October 2026
Patient Safety Learning

North-south divide opens up in ambulance services

Every ambulance trust in the south of England is missing the national category 2 response target so far this year, while all three northern trusts are inside it after a more sustained recovery.
The national target for 2026-27 is an average response of 25 minutes for category 2 calls, which include suspected strokes and heart attacks. NHS England data for April to August shows a national average of 29 minutes, almost a minute slower than in the same months last year.
North East Ambulance Service Foundation Trust (19m 13s), West Midlands Ambulance Service University FT (20m 42s), Yorkshire Ambulance Service Trust (24m 13s), and North West Ambulance Service Trust (24m 22s) are all under 25 minutes for the year to date.
However, those figures do not yet include winter. NWAS was at 24m 26s at the same point last year and finished 2025-26 on 27m.
South Western Ambulance Service FT (38m 41s), South Central Ambulance Service FT (32m 8s), London Ambulance Service Trust (31m 24s), and South East Coast Ambulance Service FT (27m 26s) are all outside the target, as are East Midlands Ambulance Service Trust (33m 59s) and East of England Ambulance Service Trust (32m 47s).
The gap has widened over the past year. South Central, South Western, and London were slower in April to August than in the same months of 2025, by 4m 40s, 4m 14s, and 1m 52s respectively, while NEAS and Yorkshire both improved by more than a minute.
Read full story (paywalled)
Source: HSJ, 5 October 2026
Patient Safety Learning

Coroner warns of risk of future deaths at mental health unit where patient was killed

A mental health trust in east London, where a man was killed by a fellow patient, has been warned further deaths may occur unless staff issues are addressed.
Hugo Flint Cahan, 34, was strangled by 22-year-old Rolando Torres-Pena at Newham Mental Health Centre, which provides care for acutely mentally ill men, in January 2023.
The coroner has sent a report to the Trust and NHS England raising serious concerns about the care the two men received.
It follows a six-day inquest in September during which the senior coroner for east London, Graeme Irvine, concluded that neglect had more than trivially contributed to Cahan's death.
On the night of Cahan's death, staff on the ward were found to have been asleep on the job and on their phones for long periods.
East London NHS Foundation Trust (ELFT) says the failings identified were "wholly unacceptable" and that it has undertaken a "significant programme of work" to improve inpatient services.
The coroner's Prevention of Future Deaths report highlights 14 concerns. These include failing to carry out "timely and thorough observations" of patients, then falsifying records "in the safe knowledge that staff on duty would not report or escalate the deception".
The document also says there were delays in starting CPR on Cahan when he was discovered, that staff misled the police as to what the patients had been doing on the night of the incident, and that staff colluded with each other to take two-hour unauthorised breaks.
Read full story
Source: BBC News, 2 October 2026
Patient Safety Learning

NHSE plan to ‘grip’ GP performance

NHS England intends to “improve operational grip” on GP performance and has warned it may lead to “contractual action”.
NHSE board papers reveal it is introducing “a range of actions” designed to “strengthen” its confidence in improved primary care performance.
The actions include: “Agreeing local improvement trajectories and recovery plans where required; [and] disseminating best practice from high performers.”
Individual practices will receive “tailored letters” detailing their performance and stressing the “potential for contractual action” should they fail to meet required standards.
The 2026-27 GP contract requires practices to deal with all patients they identify as being clinically urgent on the same day.
NHSE has set a national target of 90%, first announced in the medium-term planning framework in October 2025. The subsequent neighbourhood health framework said the NHS aimed to achieve this by March 2027.
No integrated care board area is currently reaching the target.
Practices themselves decide which patients are clinically urgent. NHSE guidance says this is “a prospective judgement made on the basis of the information available at the point of first assessment”, rather than a retrospective one.
Read full story (paywalled)
Source: HSJ, 2 October 2026
Patient Safety Learning

NHSE ‘bringing in staff without due process’

NHS England’s internal whistleblowing champions have raised concerns that the organisation is bringing in staff “without due process”.
The body’s Freedom To Speak Up annual report, to be discussed at its board meeting today, highlighted concerns that individuals were being appointed “without any formal process or job description, which the [FTSU] panel escalated to HR for investigation and response”.
It added: “The panel remained concerned about the level of corporate assurance relating to awareness of these workers, and the impact on existing teams of bringing them into NHSE without due process. As such, the panel viewed this as a governance matter that should be visible to the board.”
NHSE introduced a “consistent route” for recording new joiner details in summer, the report said.
The FTSU report for 2025-26, by chief operating officer and FTSU lead Sarah-Jane Marsh, also found:
Staff facing “bullying, harassment, or psychological abuse” from their managers and a “lack of support” from leaders when they speak up.
Concerns raised about “adherence to HR policies”.
Leaders’ engagement with FTSU had “notably reduced” following the announcement NHSE would be abolished.
Read full story (paywalled)
Source: HSJ, 1 October 2026
Further reading on the hub:
Speaking up for patient safety: A new interview series about raising concerns and whistleblowing
Key themes emerging from our ‘Speaking up for patient safety’ interview series
Patient Safety Learning

New campaign calls for choice in NHS mental health support

The National Counselling and Psychotherapy Society (NCPS) has launched a campaign calling on the government to guarantee choice of therapist in NHS mental health support, warning that people who don't respond to NHS Talking Therapies currently have nowhere else to turn unless they can pay for therapy privately.
The campaign, ‘Lost for Words’, comes ahead of the government's Mental Health Strategy for England, due to be published this autumn.
NHS Talking Therapies is the main mental health service available through GPs in England, and for many people it works well. But NCPS analysis shows the scale of the gap for those it doesn't reach:
Of the 1.8 million referrals made every year, only 19% result in reliable recovery.
Just 37% of people referred complete a full course of treatment, meaning 63% drop out before finishing.
Even among those who do complete treatment, only 50.5% reliably recover (hovering around or under this figure year-on-year).
Meg Moss, Head of Public Affairs and Advocacy at NCPS said: "Getting therapy that works shouldn't depend on your ability to pay for it. There are more than 75,000 trained, accredited counsellors and psychotherapists working in the UK right now. The question isn't whether the support exists. The question is who gets access to it."
Dr Djalil Baiou, GP, Trentside Medical Group   “While NHS Talking Therapies provides an important service, having access to an in-house counselling service gives patients an additional and genuinely different therapeutic option. In particular, the counselling approach provides an alternative to the predominantly CBT-based interventions that patients may have previously experienced or that may not suit their individual needs or preferences. We regularly see patients for whom a less structured, more exploratory form of talking therapy is valuable, and having greater choice allows psychological support to be better tailored to the individual rather than relying on a single therapeutic model”.
Read more
Source: The National Counselling and Psychotherapy Society
Patient Safety Learning

Charity threatens legal action over two-year NHS wait for ADHD and autism assessments

ADHD UK has threatened legal action against an NHS organisation over its decision to impose a minimum two-year wait for attention deficit hyperactivity disorder and autism assessments.
In a legal letter to West Yorkshire NHS integrated care board (ICB), seen by the Guardian, the charity alleges that the decision to force patients to wait at least two years for such assessments was unlawful and says it will seek a judicial review if the board fails to reverse the policy.
West Yorkshire ICB introduced the two-year minimum wait this year, affecting thousands of people with possible ADHD or autism in Leeds, Bradford, Kirklees, Calderdale and Wakefield.
West Yorkshire is not the only ICB to ration access to assessment for neurodiversity. The Guardian revealed last week that it was one of four – alongside Devon, Somerset, and North East and North Cumbria – to have imposed minimum waits amid spiralling costs due to the volume of assessments being sought. A further 11 have introduced other mechanisms to ration the number of assessments.
ADHD UK claims West Yorkshire failed to follow correct procedures, alleging the ICB breached equalities legislation, denied patients their legal right to choose non-NHS care, failed to involve patients, carers or the public in the decision, and that the decision ran counter to NHS contract regulations.
Read full story
Source: The Guardian, 1 October 2026
Patient Safety Learning

Hospital whistleblowers 'still penalised', staff claim

Two porters who won an employment tribunal against the Countess of Chester Hospital Trust said their victory shows whistleblowers are "still penalised".
Last month, the trust said its culture had "improved" after the Thirlwall Inquiry found former bosses had "intended to punish" doctors who raised concerns about nurse Lucy Letby.
A tribunal this year found porters John Crayton and Thomas Jones had been "inappropriately interrogated" after raising concerns about the way deceased patients were transported. The pair said the ruling showed they had been "unlawfully victimised".
The trust said it accepted the tribunal's findings but "encourages all colleagues to speak up".
The porters raised concerns in 2024 that they were having to transport "exposed" bodies that were not in body bags, which they said posed an infection risk.
They said there was no protection for their forearms because of the trust's policy that staff had to be bare below the elbows.
Crayton claimed there was a risk of "psychological damage" from transporting bodies showing "signs of a traumatic death".
The tribunal in Manchester found the pair had been "inappropriately interrogated" by their line manager after a senior mortuary worker identified them as the possible authors of a whistleblowing complaint submitted anonymously through the trust's Freedom to Speak Up policy.
It heard their line manager questioned them and other porters in an attempt to "get to the bottom of who had broken the chain of command".
Read full story
Source: BBC News, 1 October 2026
Further reading on the hub:
Speaking up for patient safety: A new interview series about raising concerns and whistleblowing
Key themes emerging from our ‘Speaking up for patient safety’ interview series
Patient Safety Learning
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