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The NHS in England could prevent 20,000 deaths and save £33bn a year by cutting red tape and boosting productivity, a report says. Research by the Health Foundation found the health service has been held back for decades by excessive regulation, short-term planning and insufficient capability to deliver major change. But rewiring the NHS, the world’s largest single healthcare system, by harnessing new technology, empowering staff and increasing capital investment could save both lives and money, it found. There is “substantial scope to improve outcomes within the funding already available to the NHS”, which could result in up to four extra years of good health for people on average, the report said. In terms of where deaths could be prevented, focusing on diagnosing cancer earlier and finding people with high blood pressure or conditions such as diabetes quicker would be key, it added. The report called for a series of changes, such as releasing the NHS from unnecessary regulation, reporting and compliance tasks, as well as launching a “test-and-learn” approach to scaling up things that could improve productivity, such as use of artificial intelligence. “Our analysis suggests that if the NHS in England achieved outcomes closer to the best-performing comparable health systems, without spending more each year, it could potentially result in 18,500–20,600 fewer deaths each year from treatable causes and 2.5 to 4.5 additional years that people spend in good health on average,” the report said. Read full story Source: The Guardian, 22 September 2026

Martha’s rule, which lets NHS patients, staff and relatives request a review of their care, is being expanded to every A&E in England, health officials have announced. The system gives patients, their loved ones and health workers the right to ask for a different medical team to examine the care being provided on inpatient wards and to recommend changes. It has already potentially saved hundreds of lives, official figures show. Now it will be rolled out to every emergency department in England, including waiting rooms, offering “a critical new lifeline” to improve care and save more lives, NHS England said. The system is named after Martha Mills, 13, who died in 2021 from sepsis after a bicycle accident. A coroner found she would probably have survived if she had been moved to the intensive care unit at King’s College hospital in London when she began deteriorating. In the first 16 months of the scheme after its introduction in England in 2024, helplines received more than 10,000 calls, potentially saving 446 lives, figures show. Thousands of patients were either moved to intensive care, received drugs they needed or benefited from other changes as a direct result of the calls. In June this year, the initiative was expanded to every maternity and neonatal unit in England, giving women and parents the right to a second opinion about the care of a mother or baby. From this month, it will be expanded to A&E units. It means patients, loved ones and staff in busy emergency departments will be able to call a dedicated phone number to trigger an urgent review if a patient’s condition is deteriorating and they think their concerns are not being listened to. Read full story Source: The Guardian, 22 September 2026

A major acute trust has launched two reviews over care failures potentially affecting 130 children, HSJ has learned. Nottingham University Hospitals Trust wrote to everyone on the list for its scoliosis service to inform them that it had launched an internal investigation and commissioned a separate external review. It said, “some patients may not have received the level of medical monitoring that we would expect whilst they were waiting for surgery.” In the letter sent on Friday, seen by HSJ, NUH chief operating officer Andrew Hall said the trust was “truly sorry”. It said it was not aware of specific concerns about their care, but was “seeking additional external reassurance”. In 43 of the cases, however, the trust said “immediate concern has been identified” – such as longer waits for monitoring – and in these “we have [already] reached out to those patients and their parents/carers to consider next steps.” HSJ understands NUH discovered that missed appointments may have been discovered at the end of last year, and the internal review took place earlier this year. However, it did not contact most of the families until nine months later. It has not explained the delay. It said it does not yet know the level of any harm caused. However, children whose scoliosis goes unmonitored risk deteriorating to the point where intervention becomes more complex. Read full story (paywalled) Source: HSJ, 22 September 2026

A hospital trust is providing a “pretty awful” standard of care, its interim chief executive has declared. The blunt statement was made by David Loughton – who joined University Hospitals of Liverpool Group in the summer – at a board meeting on Thursday. He said there had been “enormous progress” with partners to fix some of its clinical problems, which had to be addressed before financial gaps could be tackled. But he added: “I think you’ve got to take a cold, hard look at the quality we are providing at the present time, which is pretty awful.” Pressed for examples, he said six patients had spent a day in the discharge lounge before returning to a hospital bed on Tuesday night “because we cannot get non-emergency ambulances” to transport them elsewhere. He added: “I met in detail with the renal teams and some of the quality of what we’re providing to patients who are coming here three times a week for the foreseeable future [for dialysis] is really poor.” But he said: “The problem here is it is not down to this organisation. I’ve come into this, and I can freely say… the system leaves an awful lot to be desired at how it works together, or it doesn’t work together, and we’ve got to fix some of the problems in the community to impact in the hospitals.” Read full story (paywalled) Source: HSJ, 21 September 2026

The Patient Safety Commissioner Scotland annual report provides: A review of issues identified by the Commissioner as relevant to the Commissioner's functions during the reporting period. A review of the Commissioner's activities, including steps taken in connection with each of the Commissioner's statutory functions. Recommendations arising from those activities.

A woman in her third trimester of pregnancy was cared for in a surgical area of the hospital following a non-pregnancy related surgical procedure. During her recovery, she went into labour; there were delays in recognising her condition and in assessing the wellbeing of the baby, who died before birth. Nursing staff did not have clear guidance, support, or easy access to midwifery/obstetric teams or care plans to help them care for the woman safely.

Sandra Igwe MBE is the Founder and CEO of The Motherhood Group and Mumbrite, author of My Black Motherhood, and a Topic leader for Patient Safety Learning’s online platform, the hub. In this blog Sandra draws on her own personal and professional experiences to illustrate why Black maternal mental health is a patient safety issue.

AI is already being introduced into workflows in the NHS, and in the coming years it will undoubtedly become part of the day-to-day practice of most doctors. But what happens when AI contributes to patient harm? Unlike doctors, an AI system cannot be sued under English law. Legal responsibility may instead fall on the clinician, healthcare provider, developer, or manufacturer, depending on what exactly went wrong and why. NHS Resolution, which handles clinical negligence claims involving NHS trusts and general practices, has already received its first cases in which “the use of AI in delivering patient care is a potential factor.” The General Medical Council (GMC) has also revealed that it has received referrals about doctors misusing AI systems. These claims and complaints are likely to increase in number. The decision to use AI should be a considered one, looking at the pros and cons of the technology. This BMJ articles gives doctors practical tips to use AI safely and responsibly.

Improving productivity will be critical if the NHS is to deliver better outcomes for patients and to reduce future spending pressures by almost 10% by 2040. This NHS Productivity Commission and Health Foundation report sets out the conditions needed to deliver change.

Almost every hospital in the United States has run a patient safety initiative in the past five years. Most have run several. High reliability training, safety huddles, event reporting refreshes, zero-harm campaigns, culture surveys, action learning collaboratives. If you are a hospital executive, you have almost certainly authorised more than one. Now ask a harder question. How many of those initiatives are still producing measurable improvement today? Not the ones with a completion date on the project plan. The ones with durable, verifiable change in the outcomes they were designed to move. For most hospitals, honestly answered, the number is smaller than the number of initiatives launched. That gap is the real patient safety problem in American healthcare. And no new framework will close it. This article in Becker's Hospital Review looks at the the pattern that repeats across new initiative launches.

Concerns have been raised about NHS England watering down a key target for its controversial “advice and guidance” scheme, just weeks ahead of the October deadline. The fears surround plans to create “single points of access” for all primary care requests, other than urgent suspected cancers, which trusts were set a target to introduce for 10 specialties by next month. Instead of GPs routing referrals and A&G requests (where they get advice from a specialist) separately, the SPoA model is meant to send all requests via a single route, which NHSE believes will help reduce avoidable referrals and outpatient appointments. However, upgrades to the e-Referral System have been delayed, and NHSE has been forced to allow trusts to go live with incomplete SPoA models. Under an interim arrangement, A&G requests and referrals can enter the same SPoA service, but will arrive through separate e-RS routes, and will have to be managed on separate worklists, which experts said “appear to introduce fairly significant compromises”. Interoperability problems with the e-RS, which make it harder to share clinical information and track patients through pathways, were also identified in a recent report by the Health Services Safety Investigations Body. Read full story (paywalled) Source: HSJ, 18 September 2026

Despite having some of the highest death rates of any psychiatric condition, patients with eating disorders are being failed by a system that can’t cope with surging demand. In this BMJ feature, Emma Wilkinson looks at the state of services.

About 20,000 disclosures of domestic abuse are estimated to be made to maternity services in England every year, analysis has found. The figures are likely to be an underestimate of the true scale of disclosures, according to experts, highlighting the role maternity professionals play in identifying abuse. About 3.3% of maternity bookings made within NHS trusts across England involved a disclosure of current or non-recent domestic abuse. Applying this proportion to national NHS maternity bookings activity suggests there are approximately 20,000 disclosures of domestic abuse made within maternity services in England every year. Gill Walton, the chief executive of the Royal College of Midwives, said the findings “lay bare” something that midwives already know from their day-to-day practice. “Midwives are often the only professional a pregnant woman sees regularly and alone, which makes them uniquely placed to spot the signs of domestic abuse and respond with care,” Walton said. “But recognising a disclosure is only the first step – staff need proper, specialist training to know how to respond and services need the time and resources to follow through with support, so that no disclosure is ever a missed opportunity to protect a parent and their baby. Experts have also called for midwives to receive adequate support and training on handling such domestic abuse disclosures, while also working long hours on busy maternity wards that can also face staff shortages. “Midwives and other maternity staff play such a crucial role when it comes to reporting disclosures of domestic violence which are made to them. However, maternity staff also need better support so they know what the next steps are regarding what to do with these disclosures,” Veronica Oakeshott, the interim head of external affairs at Women’s Aid, said. Read full story Source: The Guardian, 20 September 2026

Adults with severe mental illness are nearly five times more likely than their peers to die from serious physical diseases before the age of 75, according to research. The analysis of NHS data by the Rethink Mental Illness charity reveals that people with severe mental health problems die 15-20 years earlier than the wider adult population, largely due to preventable physical conditions. Rethink’s calculations show that adults under 75 with serious mental ill health – defined as those referred to specialist secondary mental health services – are 6.3 times as likely to die from liver disease, 6 times more likely from respiratory illness, 3.8 times more likely from cardiovascular disease and 2.3 times as likely from cancer. They are also 14.6 times as likely to die due to suicide, compared with those who were not referred. Overall, they are 4.8 times more likely to die before the age of 75 than the general population. For some conditions, these health inequalities are the starkest to date. For working-age adults living with a mental illness, the number of deaths from cardiovascular disease and cancer are at their highest levels since records began, each with more than 24,000 deaths in the 2022-2024 reporting period, the charity calculated. Cancer, cardiovascular disease, liver disease and respiratory disease accounted for more than half (56.5%) of deaths for 18 to 74 year olds with severe mental health problems in England during this period. The report identifies a number of factors driving this excess mortality, including poverty, poor housing, higher rates of smoking, weight gain from medication, physical inactivity, and fragmented care. But the authors conclude that “diagnostic overshadowing” – where physical symptoms are wrongly attributed to mental illness – means potential illnesses are not always properly investigated and treated. Read full story Source: The Guardian, 20 September 2026

Health economist Anita Charlesworth will independently co-chair a “reformed” National Cancer Board, seven months after the government’s cancer plan promised a body “accountable for delivery” of its commitments. The plan, published on 4 February, said the board would be chaired jointly by the Department of Health and Social Care and an independent figure from the cancer community, and would publish annual progress reports and an in-depth review after three years. Ms Charlesworth will co-chair with Mark Cubbon, Manchester University Foundation Trust chief executive and NHS England’s elective care, cancer, and diagnostics director. DHSC said the board would scrutinise progress against the plan’s more than 100 commitments, identify which areas were falling behind and advise ministers on further action. Its first task is a set of standards the NHS is missing. The 28-day faster diagnosis threshold rose to 80% at the start of 2026-27 and has not been met since; July’s 79.3% was the best of the four months so far. Read full story (paywalled) Source: HSJ, 21 September 2026

The Maternity and Newborn Safety Investigations (MNSI) programme has published a new report setting out a number of areas in which care could be improved for women receiving intrapartum care at home. The report provides a series of safety observations and prompts for NHS trusts on topics such as staffing availability, training and guidance, and communications between different care professionals. The publication is based on learning and insights gained from the analysis of 59 maternity investigation reports (produced between 2018 and 2025) by both the Healthcare Safety Investigation Branch (HSIB) and MNSI. These investigations are carried out when they meet MNSI criteria and relate to early neonatal deaths, stillbirths and severe brain injury in babies born at term following labour and maternal deaths in England.

Transformative Simulation considers how simulation can be intentionally used beyond education to understand and contribute to change within healthcare systems. The Involvement Simulation-Based Intention focuses on using simulation to structurally involve patients, carers, communities and other diverse and under-represented groups in understanding healthcare culture and systems and shaping how care is designed and delivered. This resource from hub topic lead Sharon Weldon brings together a short Transformative Simulation thought piece, visual explainer and selected examples from the literature demonstrating how simulation has been used to bring different forms of knowledge and experience into patient safety and healthcare redesign. Further resources from Sharon on Transformative Simulation: Using simulation to improve patient safety and healthcare systems: The Improvement Intention Using simulation to strengthen workforce participation, belonging and wellbeing: The Inclusion Intention Using simulation to identify patient safety challenges: The Identification Intention

The Uganda Alliance of Patients' Organizations has produced three videos for World Patient Safety Day 2026.

SACCIA is not a set of communication rules to memorise. It is a framework for understanding, developing and applying the communicative competencies that enable people to build shared understanding together.

Twenty women underwent mastectomies unnecessarily while being treated for breast cancer, an NHS trust in north-east England has told the BBC. They were among hundreds of patients who came to harm during treatment at the breast unit of the County Durham and Darlington Foundation Trust (CDDFT). The admission comes in the wake of revelations about serious failures in the unit, as reported by the BBC last year. Dozens of affected women and their families contacted us after we reported concerns about serious failings at the trust's breast cancer unit. These included: A high number of mastectomies compared with other NHS trusts. Operations that were carried out "too quickly". Outsourcing of some treatment to private clinics run by the trust's breast cancer clinical lead - an arrangement that one independent expert said created "a clear conflict of interest. Patients described the shock they had felt on being told a mastectomy (the removal of all or part of a breast) could have been avoided, as well as the psychological and physical pain that many still live with. CDDFT is now carrying out an internal review of breast cancer cases between January 2023 and February 2025, alongside the cases of 640 former patients who contacted a dedicated helpline. It says that cases have also been identified where cancer diagnoses were missed or delayed. Some of these patients subsequently saw their cancer spread. Last year, BBC News reported that nearly £6m had been paid by the trust over six years to breast cancer diagnostic clinics and surgery companies run privately by Mr Amir Bhatti, who was CDDFT's clinical lead for breast services from 2013-24. Concern about this arrangement was raised in a 2025 review into the running of the trust carried out by governance specialist Mary Aubrey, She said outsourcing patient appointments had created financial incentives which were potentially "a risk to clinical standards". Mr Bhatti has now been suspended from carrying out clinical practice but is still employed by the trust on full pay. Read full story Source: BBC News, 18 September 2026 Related reading on the hub: Report of the independent Inquiry into the issues raised by Paterson

Pennsylvania is seeking emergency assistance from the US Centers for Disease Control and Prevention (CDC) as a major measles outbreak spreads across the state. The state warned the request could be withdrawn unless the federal agency publicly recognises four measles-associated deaths reported by the state. The Pennsylvania department of health has begun the process of requesting CDC emergency support known as an Epi-Aid, according to a letter reviewed by the Guardian. The letter was first reported by Reuters on Thursday. Debra Bogen, Pennsylvania’s secretary of health, outlined the condition in a letter sent on Wednesday to the CDC director, Erica Schwartz. “The CDC’s choice not to publicly recognize ⁠the deaths undermines our response,” Bogen wrote. “For this reason, if CDC is unable to transparently and accurately communicate information about those measles-associated deaths, the department will respectfully rescind our request for a CDC Epi-Aid.” The development comes amid an ongoing dispute involving Josh Shapiro, the state’s Democratic governor, and Robert F Kennedy Jr, the US health secretary, over the state’s handling of the outbreak and how measles-related deaths are being counted. Read full story Source: The Guardian, 17 September 2026

Major concerns have been raised about patient and staff safety on wards at a Welsh hospital in a damning report by the watchdog. The investigation into two mental health wards at the University Hospital Llandough in Cardiff by Healthcare Inspectorate Wales (HIW) comes just months they published a similar report raising concerns about other mental health units at the hospital. An unannounced inspection at the Meadow and Daffodil mental health rehabilitation services in June found mould, ceiling leaks, faulty showers and bathing facilities at the hospital. Inspectors also identified "significant concerns" regarding mandatory training compliance and were not satisfied that sufficient staff could manage risks safely. HIW said "urgent action was required at the unit" to address immediate patient staff and safety concerns as a result. Progress across the health board will be monitored closely as a result of the recent inspections, the watchdog added. Read full story Source: Wales Online, 17 September 2026