All Activity

Successive governments in England have been “asleep at the wheel” on social care, leaving the system to grow as a chaotic patchwork of local services with no clear vision, Louise Casey, the head of the social care commission, is to warn. Lady Casey, who is preparing proposals for a big review of adult social care, will say the result is that in effect “no one is in charge” of a system that provides vital services for millions of vulnerable people. People’s experiences of care have varied depending on where they live, with different standards, assessment processes and waiting times, while the private care sector has grown dominant and regulation of services has often been ineffectual, she will say. She will add that England has no clear “system stewardship” for social care, making it difficult for governments to target improvements to services or translate policy into practice, unlike in comparable countries such as France, Germany and Japan. Read full story Source: The Guardian, 11 November 2026

Disabled people are having to wait up to two years to get a wheelchair because of delays involving NHS bodies and private firms that make them. The situation is revealed in a report by the Public Service Ombudsman, Paula Sussex, who said hold-ups were having profound consequences and limiting wheelchair users’ ability to lead independent lives. In one case a three-year-old boy with cerebral palsy was unable to start nursery at the same time as his twin brother because he had to wait seven months for a wheelchair. He hurt himself several times when he fell from an adapted buggy his parents were using while they waited. Sussex launched an investigation into NHS wheelchair provision after a sharp rise in complaints – from eight in 2020-21 to 110 in 2025-26. Four out of five relate to the handful of private firms that provide wheelchairs to at least half of all children and adults who need one to help them lead independent lives. Most are about people who need a wheelchair having to wait longer than the supposed 18-week maximum to receive either the device or parts for it. “For people who rely on a wheelchair, delays, unsuitable equipment or poor repairs can affect every part of their life”, said Sussex. “There can be profound consequences, from physical pain and emotional distress to limiting their ability to lead full lives.” Read full story Source: The Guardian, 11 November 2026

NHS bosses have warned of a “punitive” inspection culture at the Care Quality Commission (CQC), two years into the regulator’s recovery from a damning review. Just one in five trust leaders (21%) believe the CQC is making changes that will improve its long-term performance, with 27% disagreeing, 37% neutral and 16% unsure. The NHS Alliance, which represents most trusts and integrated care boards, surveyed 166 chief executives, chairs, company secretaries, and medical and nursing directors at 116 trusts in August. Its report says “numerous” leaders described the regulator’s approach as adversarial. One trust chair said inspection teams “arrive with conclusions in advance, and use evidence inappropriately to justify those conclusions”. A director at another trust said: “The way they run the inspection is aggressive.” Another leader said: “The CQC used to add value – it doesn’t any more, and has lost credibility.” Just 12% cent agree the CQC’s current approach supports innovation and the spread of good practice, while 60% disagree. Fewer than two in five (38%) say it is supporting their trust to improve the quality of care, with 31% disagreeing. Read full story (paywalled) Source: HSJ, 11 November 2026

Medical assistance in dying (MAID) is a process where cognitively competent adults suffering from a terminal illness, yet alive in the final six months of life expectancy and capable of making their own healthcare decisions, may choose to end their lives with assistance from their doctors. They may request prescriptions for medications that they can ingest at a time and place of their choosing to end their life, on their own terms. In his previous commentary, Dan Cohen, an international consultant in patient safety and clinical risk management, and a Trustee for Patient Safety Learning, discussed how MAID aligns with the principles of biomedical ethics. In this commentary, he discusses why MAID is not 'suicide' in the traditional sense of how this word is used. *Content warning* Some of the themes included in this blog people might find upsetting. 

Rosemary Nayler says she was repeatedly told that taking the epilepsy drug sodium valproate while pregnant would not affect her unborn child. But it is thought thousands of children in the UK have been left with disabilities caused by the medication since the 1970s. Her daughter, Nadia Williams, is now 37, registered blind and deaf, is autistic and has mobility issues. Nayler is among thousands of parents calling for the government to "admit where they've gone wrong". Over the last decade, instructions for doctors and patient leaflets have stated valproate should not be used during pregnancy unless there was no safer alternative and only after a careful discussion of the risks. Rosemary, from Evesham in Worcestershire, had her first epilepsy attack when she was about 30. "I'd already got three young children by this stage who were all born perfectly normal and quite happy and have developed no problems throughout their lives. They're all way into their 50s now." But by the time she became pregnant with Nadia, aged 34, in the late 1980s, she was already taking sodium valproate on the advice of doctors. "Every time I had an epileptic attack I was told that it was 'far better for me to... keep on taking the tablets' and they just kept increasing the dosage. "We queried... if it was going to affect the foetus in any way and we were clearly told that 'no, there was no effect on the children'." Rosemary said she wants "the government to admit where they've gone wrong, the fact that we should have been told about these things and these possibilities way back then". Her daughter added she was "terrified of the future". Read full story Source: BBC News, 9 November 2026 Further reading on the hub: First Do No Harm. The report of the Independent Medicines and Medical Devices Safety Review (8 July 2020) Mums v Big Pharma (BBC iPlayer, 9 November 2026) Sodium Valproate: The Fetal Valproate Syndrome Tragedy

This report presents results from the NHS Alliance’s first governance and regulation survey, building on similar publications by NHS Providers. It is the first in a three-part series, focusing on trust leaders’ experiences of the Care Quality Commission (CQC) over the past year. The second report will focus on ICB and trust leaders’ experiences of NHS England’s (NHSE) oversight and regulatory approach. Conducted in August 2026, the findings and recommendations in this report are based on the 166 responses from 116 trusts (57% of all trusts). All regions and trust types are represented. Respondents included chief executives, chairs, company secretaries, medical directors and nursing directors. Our analyses and interpretation are supplemented by free-text responses and insights gathered via a series of in-depth interviews and wider engagement with NHS leaders.

The way that wheelchair services are designed, funded and organised across the NHS is affecting the safety, dignity and independence of people who rely on them.  This Public Services Ombudsman report shows that complaints about wheelchair services have significantly increased over the last five years. It make recommendations in three areas for a more consistent, national approach to improve the lives of wheelchair users: strengthen national oversight, data and quality assurance build ICB capability to commission sustainable, person-centred services measure services by people’s experiences and outcomes.

Two mums from north west England tell the story, based on their experience, of taking on a drugs company, doctors and the government, fighting a scandal that led to at least 20,000 babies being born disabled - the truly shocking scandal of sodium valproate.  The film reveals, for the first time, the ‘David v Goliath’ battle as they search for answers and fight for justice for their children. Further reading on the hub: First Do No Harm. The report of the Independent Medicines and Medical Devices Safety Review (8 July 2020) Sodium Valproate: The Fetal Valproate Syndrome Tragedy

The Health and Social Care Committee commissioned an independent expert panel (IEP) to carry out an evaluation of the transition from child to adult health and social care services. The report highlights how young people, especially those with complex physical and mental health needs, are failed by services that abruptly change or cancel the support they need when they turn 16 or 18. It points towards redesigning systems to remove abrupt switches from children’s to adults’ services based on age. Evidence the IEP received suggested instead basing transitions, pace of change and assumptions about independence, on careful assessment of the individual child’s needs and wishes.

If your organisation operates in a high risk, or high threat location, or in the course of day-to-day work staff are likely to face traumatic or potentially traumatic situations, then you should consider TRiM. What is TRiM? TRiM is a trauma-focused peer support system designed to help people who have experienced a traumatic, or potentially traumatic, event. TRiM Practitioners are non-medical personnel who have undergone specific training allowing them to understand the effects that traumatic events can have upon people. They are not counsellors or therapists, but understand confidentiality and are able to listen and offer practical advice and assistance. TRiM originated in the UK Armed Forces and the model is based on ‘active monitoring’, that means keeping a watchful eye on individuals who have been exposed to a traumatic event, whether that person has been directly involved or involved from afar.

Families whose children have metachromatic leukodystrophy (MLD) have warned it will be too late for many to receive treatment unless a review into newborn screening is brought forward. MLD is a genetic condition which affects the brain and nervous system, causing a progressive loss of physical and mental abilities - it affects roughly one in 40,000 children. A treatment called Libmeldy on the NHS can save children's lives if it is caught early enough. The UK National Screening Committee's review opted against newborn screening over uncertainties about test accuracy, cost, and the effectiveness of treating the condition before symptoms start. The next review is due between 2029 to 2030. Testing for MLD is already widespread in Europe and two families across the North East and Cumbria are campaigning for the UK to follow suit. Campaigners want screening to be included in the newborn blood spot test - formerly called the heel prick test - which checks for rare but life-threatening conditions, usually taken at about five days old. Read full story Source: BBC News, 10 November 2026

Former prime minister Lord David Cameron is leading calls for drugs that have previously been rejected for use on the NHS to be approved for treating Alzheimer’s. Lord Cameron has joined dozens of dementia specialists in the plea, and has also called for a maximum 18-week wait for a diagnosis of the disease, the Telegraph reported. While treatments such as lecanemab and donanemab have advanced the field of drug treatments, other medicines are far cheaper and experts know already about the risk of side-effects for some of them. They were licensed in 2024, but are not available on the NHS outside clinical trials. Lord Cameron, president of charity Alzheimer’s Research UK, lost his mother to the disease in 2025. He said drugs that are effective but not currently approved should be unlocked. “As prime minister, I was proud to launch the National Dementia Challenge, doubling the amount of investment into research for dementia treatments and kick-starting the fightback against this terrible disease that destroys so many lives,” he told the Telegraph. “More than a decade on, huge progress has been made, meaning we now have treatments available that can slow the progression of Alzheimer’s disease. “However, we urgently need to find ways to unlock access to these dementia drugs, and others on the way, so people can benefit from the amazing progress that is being made and from new innovations on the horizon.” Read full story Source: The Independent, 9 November 2026

Stopping weight loss injections could double the risk of heart attack, stroke or death for people with type 2 diabetes, a study has suggested. The research focused on people with type 2 diabetes who had no established heart disease when the study began. It found that heart health was better among those who remained on GLP-1 drugs than among those who came off them. GLP-1 drugs are already thought to benefit the heart, with research indicating they may reduce inflammation and improve how blood vessels function. Weight loss itself also tends to bring improvements in blood pressure, inflammation and cholesterol, all of which are good for the heart. For the research, experts examined electronic medical records from more than 300 diabetes clinics across Italy. Overall, the results suggested that the risk of a non-fatal heart attack, non-fatal stroke or death from any cause was about twice as high in people who stopped treatment as in those who continued. The researchers said this worked out at about four strokes or heart attacks per 100 people per year among those who stopped, against two per 100 among those who carried on. Read full story Source: The Independent, 10 November 2026

In this blog, Patient Safety Learning’s Chief Executive Helen Hughes introduces the new Patient Safety and AI Networks hosted on the hub.

A new handbook supporting clinicians to have more effective conversations with patients living with chronic pain is now available on the GIRFT website.  The GIRFT chronic pain team brought together people with lived experience and expert clinicians to voice what they want healthcare providers to understand and communicate about the condition. Their insights have shaped the new handbook, which offers practical guidance to help all healthcare professionals explain pain in a way that is understandable, validating and empowering for patients.  The handbook features checklists of what clinicians need to know on the themes that matter most in chronic pain, and includes examples of phrasing and terminology which can help to explain points clearly and compassionately.  Co-badged by the British Pain Society, Faculty of Pain Medicine, Arthritis UK, the Chartered Society of Physiotherapy, Royal College of Occupational Therapists and the Physiotherapy Pain Association, the resource also contains an extensive list of, and links to, a range of further resources – books, booklets, videos, podcasts and websites – which may be useful to adult patients and children and young people. The term chronic pain refers to persistent pain lasting longer than three months, including both chronic primary and chronic secondary pain. One in three people over the age of 16 have chronic pain and one in five children and young people are affected, leading to significant absenteeism from work and school and ma

Over 2026, hopes that AI can help tackle some of the thorniest problems facing the NHS have continued to grow. The dominant policy questions no longer focus so much on whether AI can or should be used to improve health services, but on how best to deploy AI and assess performance. In October the Health Foundation hosted its third AI in the NHS Summit. This year’s summit brought together speakers from the UK, US, Singapore and South Korea to look at what we can learn about AI implementation from leading systems, and how the UK can conduct faster, rigorous evaluation.  Key takeaways included the uneven distribution of the benefits of AI, the difficulty of generating sufficient evidence on AI tools and how the UK can make the most of its assets. 

NHS officials are shutting growing numbers of birth centres in a “shocking” denial of a woman’s right to have a midwife rather than a doctor oversee their baby’s birth, say campaigners. Twelve birth centres – midwife-led maternity units – have closed in England since 2019. Birth centres play a key role in ensuring that women can choose whether to have their baby at a unit in a hospital run by doctors, at one where midwives are in charge, or at home. Six units have shut permanently since Labour came to power in July 2024. Four others have been closed “temporarily” for so long, up to six years, that childbirth groups fear they will never reopen. Two other birth centres closed because the hospitals where they were based have begun to fall apart and will remain out of action for several years until new facilities are built. The wave of closures and suspensions is occurring because of the NHS-wide shortage of midwives, a falling birthrate, the growing complexity of childbirth and a rise in caesarean sections. Campaigners say the loss of local childbirth services is denying women their right to choose and forcing them to travel from their home area to give birth. Read full story Source: The Guardian, 7 November 2026

Since 1991, people across the world have come together on 14 November to acknowledge World Diabetes Day. World Diabetes Day is the world’s largest global diabetes awareness initiative, bringing people together to raise awareness about diabetes, inspire action and promote accountability. This year's World Diabetes Day theme is 'Early action on diabetes' and highlights the importance of early diagnosis, access to quality diabetes care and reducing diabetes stigma. The World Health Organization (WHO) has produced a toolkit to raise awareness, start conversations and encourage early action on diabetes. Make it yours. Adapt, share and explore the resources to support action on diabetes in your setting.

When Jo Menneer was diagnosed with breast cancer, she knew undergoing treatment would be a difficult process. What she did not anticipate was the challenge of navigating the menopause afterwards. Before her diagnosis in 2022, Jo, now 55, from East Yorkshire, had been taking hormonal replacement therapy (HRT) to manage the menopause. Part of her treatment included surgery, which meant she had to stop taking HRT, and is still unable to use it. "For me personally, my menopause symptoms came back with a vengeance almost immediately," she says. "As well as recovering from surgery, which is quite gruelling, to then be mixed with hot flushes, aching limbs, brain fog, up and down emotions - I felt like I'd gone back about 10 years." According to the NHS, menopause is when your periods stop due to lower hormone levels, and symptoms usually begin between the ages of 45 and 55. However, people can experience menopause earlier or at an increased rate. This can be brought on by a number of factors, including certain hormone medicines, ovarian surgery or treatment for some types of cancer. Chemotherapy, pelvic radiotherapy, stem cell transplantation and surgery can all trigger menopause, on a temporary or permanent basis. "You're battling at the time with the diagnosis and the treatment and the surgery and how that's going to impact you," Jo explains. "I never in my life thought that it would impact my menopause and it was never discussed. So it was a bit of a shock." The Department of Health and Social Care (DHSC) said its National Cancer Plan would ensure patients had a personalised plan "so the long-term effects of treatment, including menopause, are recognised and built into their ongoing care". Read full story Source: BBC News, 8 November 2026 Further reading on the hub: Top picks: 10 key resources to support menopause Raising awareness of surgical menopause

Hundreds of thousands of vulnerable patients in England are to receive extra support from their GP as part of a £40m drive aimed at keeping them out of hospital this winter. As the NHS gears up for the pressures of the coming months, family doctors will offer 300,000 people with frailty and long-term conditions health checks, medication reviews and respiratory tests designed to prevent avoidable hospital admissions. Funded by cash reallocated from existing GP budgets for 2026-27, the scheme will allow surgeries to identify and provide extra care to the patients they believe are most at risk of becoming seriously unwell in the winter. Groups of GP practices can use £126 for every eligible patient supported. The prime minister said the scheme would be targeted at patients with heart disease, frailty and lung conditions such as emphysema and other types of chronic obstructive pulmonary disease (COPD). Andy Burnham said he was “not going to pretend this winter will be easy” but the programme would help keep people well at home and avoid unnecessary trips to hospital. “If we want to take the pressure off our hospitals this winter, we’ve got to keep people well at home. So we’re backing GPs to reach the most vulnerable people early, before a small problem turns into a trip to A&E,” he said. “People deserve the right care in the right place. And our NHS staff, who work so hard, deserve the right tools to provide it. I’m not going to pretend this winter will be easy. But with new technology, upgrades for hospitals and more care available closer to home, we’ll make sure the NHS is there for everyone when they need it.” Read full story Source: The Guardian, 8 November 2026

Fewer than 1 in 15 stroke survivors are getting the amount of therapy the NHS should provide to maximise their chances of recovery, a report has revealed. The figure was a “damning” indictment of the widespread lack of rehabilitation for patients, which was hindering their chances of regaining physical and mental function, the Stroke Association said. The finding is disclosed in the latest annual report of the Sentinel Stroke National Audit Programme (SSNAP), which is based on stroke care data from hospitals in the three countries. Almost 100,000 people a year in the UK have a stroke. It is the single largest cause of complex disability and can leave survivors struggling to walk, talk or swallow. The ageing population, and an increased number of people with high blood pressure or diabetes, could cause the annual figure to rise to 115,483 by 2030. All stroke patients should get three hours of physiotherapy, speech and language therapy, and occupational therapy to help them recover from the brain injury they have suffered, whether they are still in hospital or have returned home to continue their rehabilitation. That is set out in National Institute for Health and Care Excellence guidelines intended to guide NHS practice in England and Wales. They are also followed in Northern Ireland. However, during January to March this year – the latest figures available – only 6.4% of patients received that amount, down from the 7.5% who did so in October to December 2024. Read full story Source: The Guardian, 9 November 2026

Records of child, neonatal, and maternal deaths held by a trust’s medical examiner service were “methodically and selectively” deleted, an external investigation has found. Nottingham University Hospitals Trust discovered the files were missing in July 2024, and they were recovered within the next month. At the time, the trust was the subject of an independent review of its maternity services led by senior midwife Donna Ockenden, the largest such inquiry in NHS history. Families involved in the review were not told about the deletion until February 2025, more than six months after it happened. Nottinghamshire Police launched their own investigation shortly after it was made public and concluded it was most likely done “intentionally/maliciously”. NUH commissioned the independent review, done by a barrister, in the summer of 2025, and the findings were set out in board papers today (6 November), first obtained by Sky News. The review concluded the files – which contained bereavement and medical examiner’s records relating to child deaths between 2019 and October 2022 – had been “methodically and selectively deleted and that the deletion was intentional rather than accidental”. It could not establish who was responsible for this due to the lack of “auditing functionality” at the time. It also found the shared drive with the files was “widely available and was not consistently removed when individuals no longer required it”. Read full story (paywalled) Source: HSJ, 6 November 2026