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News article
The government is rolling out a Healthy Babies programme to every local authority in England, as part of its efforts to expand a Sure Start-type system of help for deprived children and families. It aims to support parents with infant feeding, their mental health and building strong bonds with their babies, alongside health visits, midwifery care and wider services. The scheme seeks to follow the principles of Sure Start, a network of centres offering integrated services for the under-fives and their families, launched in 1998 under a Labour government. Sure Start was seen as one of that government’s major successes, with one study saying it generated longer-term savings worth twice the system’s cost. But much of that scheme was dismantled amid massive spending cuts by the Conservatives. The new policy of family hubs will commit £500m to opening 1,000 centres from April 2027. Announcing the expansion of the Healthy Babies programme at the Labour conference in Liverpool, Yvette Cooper, the Health and Social Care secretary, is expected to say that the programme will reach up to 1,000 family hubs over the next two years. Since the election the Labour government has opened new family hubs across England, but more than half of local authorities have hubs without Healthy Babies services. “Something is missing in half of communities … the Healthy Babies services – mental health support for mums and dad, the feeding and bonding support for your new baby. That changes now,” Cooper will say. “We will bring back the Sure Start health services into every family centre. One of the Labour party’s greatest achievements, restored to families throughout the land.” Read full story Source: The Guardian, 30 September 2026 -
Julia Hande joined the community
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News article
Details of the serious concerns raised by the Care Quality Commission about the collapsing Humber Health Partnership hospital group have been uncovered by HSJ. The regulator served section 29A warning notices on group members Hull University Teaching Hospitals Trust and Northern Lincolnshire and Goole Foundation Trust in July in response to ongoing patient safety concerns. The warning notices, which have now been seen by HSJ, show the CQC is unhappy with the rate of progress achieved by the group. This was “insufficient due to the scale of work required”, and meant “patients remained at risk of harm”. A review of serious incidents undertaken by the watchdog found “limited evidence” that learning was taking place, with the same factors “repeatedly” identified. These included staffing pressures and inconsistent policies, particularly on medicines management. The group was also criticised for its poor record on infection control. The CQC said these failings were “part of a longer-term pattern, with little evidence of improvement over time”. Read full story (paywalled) Source: HSJ, 29 September 2026 -
News article
The chair of a major public inquiry has admitted they are often “hugely expensive”, time-consuming, and popular with politicians who are keen to pass the buck to the next minister. Tom Kark KC, who recently completed the Muckamore Abbey Hospital Inquiry into serious abuse at a Belfast mental health unit, told HSJ’s Patient Safety Congress in Telford today that such probes address a clear public need, but typically do not give bereaved families closure. He also questioned why once the chair’s job is finished, they relinquish any power over their recommendations, and how they are implemented. The leading lawyer, who was also chief counsel to the Mid Staffordshire public inquiry and carried out a review of the Fit and Proper Person Test (FPPT), warned in addition that the government’s plan to regulate managers must not become a “weapon or a stick to punish poor performance”. Mr Kark told the event: “When something goes wrong, particularly in the NHS… there is very often a knee-jerk reaction to set up a public inquiry. Politicians in general quite like public inquiries because generally, by the time a public inquiry is reported, that [politician] has gone, and it’s the next one’s problem. “There is certainly a problem about the timing of public inquiries and how long they take. We [Muckamore] actually took four years, and we were regarded as being extremely rapid… and that tells you something.” Read full story (paywalled) Source: HSJ, 29 September 2026 -
aimeeholt joined the community
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Content ArticleAnonymous posted an article in Florence in the Machine
Martha’s Rule gives patients and families a vital way to escalate concerns when they believe a patient’s condition is deteriorating and they are not being heard. However, increased awareness of Martha’s Rule has also led to more calls about complaints, waiting times and other issues outside its intended scope. In an anonymous blog, a critical care outreach nurse in an acute NHS Trust explains why, as the scheme expands, the NHS must preserve its patient-safety focus by setting clear expectations, providing suitable routes for other concerns and supporting staff who handle difficult calls. -
Content Article
In an era of patient-centred care and growing concern over misconduct in medical settings, why do women still lack the right to choose women consultants for examination and treatment? Equality legislation has resulted in significant improvements in the workplace for women, both in terms of pay and career paths albeit with some way still to go. It is startling, however, just how primitive our society remains in respect of the treatment of women in other areas of their lives. This article from Charles Davey addresses one of these areas – medical care, specifically the right for women to elect examinations and care by women medical practitioners. -
Content Article
To mark World Patient Safety Day and the 2026 theme of ‘Safe care for noncommunicable diseases’, the Royal College of Surgeons of Edinburgh (RCSEd) has produced a series of blogs. Operating as One to Deliver Safe Care for Life Focus on Rare Congenital Conditions Transforming Transition & Lifelong Outcomes Safety Hurdles of the Head and Neck Cancer Pathway - Safe Care Strategy Safe Surveillance is a Systems Issue Patient Safety in Cardiac Surgery is a Team Game Patient Safety in Major Joint Replacement Surgery How Could You Have Forgotten My Catheter Doctor, I Haven't How Metabolic Bariatric Surgery is Changing How We Can Prevent, Repair and Learn -
Content Article
The concepts and arguments in this article use multiple sclerosis (MS) as an example (I have had it for 35 years), but they can be applied across many diseases. MS patients are handed detailed, formalised information about the risks of taking a drug and vague, inconsistent, information about the risks of leaving the disease untreated or undertreated. This opinion piece argues that the imbalance distorts decision-making, often in the direction of delay, and that the usual justification (not wanting to frighten people) makes the problem worse. It asks who is actually placed to assemble long-term comparative data on delayed and low-efficacy treatment, names registries and industry as the candidates, and sets out what a patient-facing 'disease risk sheet' would need to contain. Speculation is labelled as such. It ends with a direct challenge to anyone working in MS research, registries, charities or industry to say whether such a dataset already exists. Read it if you work on treatment decision support, risk communication or registry outputs, or if you want the case for why the current comparison is not a fair one. This article was first published on LinkedIn on 14 January 2026. Yesterday
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roselyn adams joined the community
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EventThis conference brings together leading experts and experienced NHS practitioners to provide a practical guide to embedding Martha’s Rule across hospital services. The conference will examine the caregiver’s perspective, implementing the three core components, communicating effectively with patients and families, and overcoming cultural and operational barriers. The programme will explore how to embed the Patient Wellness Question into routine care and ensure concerns are recorded, reviewed and acted upon. Delegates will consider how to use the six core standards to assess reliability, identify gaps and provide assurance to senior leaders. The conference will also focus on using Martha’s Rule data to understand outcomes, identify variation and improve wider deterioration and escalation systems. Legal, governance and human factors considerations will be discussed, including independent rapid review, documentation, psychological safety and responding constructively when concerns are escalated. Martha’s Rule forms part of the wider national approach to managing acute physical deterioration through prevention, identification, escalation and response—the PIER approach. The day will include interactive case discussions and practical exercises to support delegates to translate national requirements into reliable everyday practice. This conference will enable you to: Reflect on Martha’s story and the importance of listening to patients, families and carers. Understand the three core components of Martha’s Rule and the March 2027 implementation requirement. Embed the Patient Wellness Question into routine care and escalation processes. Use the six core standards to assess reliability and identify areas for improvement. Communicate Martha’s Rule clearly and ensure equitable access. Use implementation data, feedback and outcomes to drive improvement. Understand key governance, legal and human factors considerations. Develop a culture where patients, families and staff feel able to raise concerns. Integrate Martha’s Rule with existing deterioration pathways and the PIER approach. Support continuing professional development and provide evidence for revalidation. Register hub members receive a 20% discount. Email [email protected] for discount code.
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EventA different approach to Structured Judgement Reviews (SJRs); using them as a triage tool and avoiding the use of poor and very poor to better align with PSIRF. This course looks at moving SJRs away from questions of avoidability of harm and instead looks at how they can be used to determine what type of learning response should follow a patient’s death. The explicit judgements of poor and very poor that are in traditional SJR models are no longer helpful and delegates will be provided with updated and positive alternatives that focus on organisational learning. Who should attend Healthcare professionals tasked with deciding on an appropriate learning response following the death of a patient. Healthcare professionals who undertake Structured Judgement Reviews who wish to align these with PSIRF principles. Key learning objectives Where SJRs fit in the overall clinical governance structure of their organisation, why they are being conducted and what questions they are designed to answer How to organise case notes for effective review; use of timelines What other sources of evidence to consider Making explicit judgements around quality of care; evidence base and standards used When and how to escalate potential issues with professional conduct Register hub members receive a 20% discount. Email [email protected] for discount code.
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EventAny staff with responsibility for implementing the duty of candour and/or PSIRF and those responsible for quality; safety; clinical governance; safety investigations; complaints; CQC compliance; or patient experience/ involvement would benefit from attending this one-day training. The course will provide participants with an in-depth knowledge and understanding of how to not only comply with the duty of candour and the Patient Safety Incident Response Framework (PSIRF), but to do so in an emotionally intelligent way, with empathy and compassion for all involved. Practical guidance on complying with the regulations and guidance The “grey areas” and what people most often get wrong Using emotional intelligence to understand the difficult emotions experienced by patients/those closest to them and staff following patient safety incidents What empathy and compassion mean in practice Handling difficult and emotive conversations well Making a meaningful apology How Duty of Candour and PSIRF work alongside other policies and procedures including complaints; litigation; Martha’s Rule and the soon to be introduced “Hillsborough Law” How the new “Harmed Patient Pathway” can help you get it right 7 How to ensure communication moves beyond compliance and frameworks but remains emotionally intelligent and personal Register hub members receive 20% discount. Email [email protected] for discount code.
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EventA clear, factual walkthrough of what happened, where, and when — and how a patient safety concern became blurred, delayed, and distorted by a disciplinary process. Delegates will explore the key lessons from the NHS internal investigation and the emerging recommendations from the Thirlwall Inquiry, with a focus on whether similar vulnerabilities exist within their own Trust. What to expect: The Key Facts: What Happened, Where, and When How a Patient Safety Issue Was Blurred by a Disciplinary Investigation Key Lessons from the NHS Internal Investigation Key Lessons & Recommendations from the Thirlwall Inquiry Could This Happen in Your Trust? Who should attend? This course is open to Board members, Senior leaders, Patient Safety Specialists, Triumvirates, Safety and Governance Teams. Register hub members receive a 20% discount. Email [email protected] for code.
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EventThis practical masterclass introduces statistical process control in a clear, accessible and confidence-building way. Participants will learn how to understand variation, choose the right chart, interpret signals, avoid common mistakes and use SPC to support better improvement, assurance and decision-making. Healthcare teams are surrounded by data, but data alone does not lead to better decisions. Many services still rely on red, amber and green ratings, two-point comparisons, averages, rankings and narrative explanations that can obscure whether performance is genuinely changing. Statistical process control (SPC) offers a more useful way to understand variation over time, distinguish signal from noise, and decide when action is needed. This masterclass will demystify SPC for all attendees. It will explain the core concepts in plain language, using practical healthcare examples rather than mathematical theory. Participants will learn why plotting data over time matters, how common cause and special cause variation affect decision-making, when to use run charts, along with other chart types, and how to interpret process limits and rules for special cause variation. The session will link SPC to national expectations around improvement, productivity, quality, safety, operational performance and better use of data. It will support participants to move beyond simply producing charts towards using SPC as a practical tool for learning, improvement, assurance and leadership conversations. By the end of the masterclass, participants will be able to use SPC more confidently in improvement projects, service reviews, board reports and day-to-day management. This masterclass is aimed anyone who wants to use data for improvement and performance more effectively, including clinicians, operational managers, service managers, analysts, transformation leads, quality and safety teams, and executives and board members. It is particularly relevant for people who: Regularly review performance, quality, safety, access, flow, workforce or patient experience data; Support improvement projects or transformation programmes; Need to understand whether changes are leading to real improvement; Want to avoid overreacting to normal variation or missing important signals; Are involved in reporting data to teams, committees, executives or boards; Are new to SPC or have used charts but want greater confidence in interpretation. No advanced statistical knowledge is required. The session is designed for people who want SPC explained clearly, practically and without unnecessary jargon. Register hub members receive a 20% discount. Email [email protected] for code.
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News article
The United States government’s decision to block a major global declaration on pandemic preparedness “severely weakens” the effort, and signals intent to disrupt international cooperation, says Prof Lawrence Gostin, a leading expert on global health law from Georgetown University. The United Nations general assembly had been due to adopt a political declaration on pandemic prevention, preparedness and response on 25 September after a high-level meeting on the subject. The document would have seen countries agree to work together in solidarity to tackle global health threats and express concerns that the world remains unready to deal with future pandemics. However, the US delegate said it was “not in a position” to support the text, blocking its adoption by consensus – the UN process whereby negotiated documents are assumed to be agreed unless there is an objection. Dr Erica Schwartz, the director of the Centers for Disease Control and Prevention, said critical issues remained unresolved, referring to “the inclusion of divisive ideologies that lack definitional consensus” and references within the document to ongoing, WHO-led negotiations over the fair sharing of vaccines and drugs between countries in any future pandemic. It is understood that the Trump administration was unhappy with mentions of equity and universal access to sexual and reproductive healthcare services. Earlier this year, President Trump signed executive orders expanding a “global gag” rule that bans US aid recipients from work related to abortion to also include bans on diversity, equity and inclusion initiatives and what it called “gender ideology”. Read full story Source: The Guardian, 28 September 2026 -
Bb83738cfc14b66ecef463e35d892ad4An important perspective on the future of patient experience intelligence. From a quality and patient-safety perspective, technology alone is not enough—its value comes from integrating data, patient voice, clinical workflows, and continuous quality improvement. The real opportunity is to move from fragmented feedback to actionable intelligence that helps healthcare teams identify gaps, prioritize improvement, and measure whether changes are actually improving patient experience and outcomes. Good infrastructure enables the journey; good design and strong quality governance create the value.
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PIxms joined the community
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EventJoin THIS Space 2026 to explore what works in healthcare improvement and innovation, what doesn’t, and why. Discover the latest evidence, share learning and connect with others committed to improving the quality and safety of healthcare. Evaluating AI for the NHS is there a better way? Patient and public involvement in digital transformation. Transgressive behaviour as a patient safety challenge. Improving governance of evaluation. Improving healthcare inclusively. ...and much more! Register
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News article
The winners of the HSJ Patient Safety Awards 2026 were announced last night, recognising outstanding efforts to make care safer. This year’s event attracted 427 entries, with 217 shortlisted across 25 categories. Categories included the Improving Medicines Safety Award, the Urgent and Emergency Care Safety Initiative of the Year, the Maternity, Midwifery and Neonatal Safety Initiative of the Year, and Patient Safety Team of the Year. The 25 awards span three broad areas: clinical and specialist excellence, organisation-wide change, and service and system innovation. They also include awards for digital clinical safety, surgical care, the use of data and analytics, and patient involvement. Opening the event, HSJ editor Alastair McLellan said patient safety had returned to the top of the health agenda over the past year, but warned the debate had focused overwhelmingly on maternity services. He said safety in emergency departments and acute wards was receiving less attention, with debate instead dominated by access and waiting times. He noted that long accident and emergency department waits, particularly those of more than eight hours, were strongly associated with increased mortality. Mr McLellan also praised those shortlisted for achieving improvements despite the pressures facing the NHS. He said work to prevent patient harm was not always welcomed amid unprecedented demand and the drive to recover performance, adding that the finalists’ achievements showed “what is possible in even the most unpromising situations”. Read full story (paywalled) Source: HSJ, 29 September 2026 -
News article
Hospitals are being hit by shortages of key drugs used to provide pain relief, prevent blood clots and tackle high blood pressure. Dozens of NHS trusts in England have encountered scarcities of aspirin, the painkiller co-codamol – a combination of paracetamol and codeine – and ramipril, a blood pressure tablet. Nine trusts have had problems getting enough supplies of two of those three common medications, while one ran short of all three. The shortages underline how precarious the health service’s supply chains for basic medicines have become in recent years as a result of trade disputes, global conflict and manufacturing problems. Pharmacists have said supply problems have become a “national crisis” and in some cases have left patients unable to access their usual medications for weeks at a time. Hospitals’ drug supply problems have emerged in freedom of information requests by Dr Rodolfo Catena, an expert in global health supplies at University College London, about stock levels of the three drugs. Sixty of the 184 trusts from which he sought figures responded. The most widespread shortage involved aspirin, which is used to reduce pain and the risk of blood clots. Twenty-six (62%) of the 42 trusts that responded about it had experienced disruption to their supplies between last December and March this year. Thirteen (31%) of the 42 trusts that replied on co-codamol had run short of that drug, which helps relieve muscle pain, period pain and toothache. York and Scarborough NHS trust’s supplies had been disrupted since May 2025, and Royal Wolverhampton NHS trust had trouble getting enough co-codamol for the 10 months between October 2025 and August this year. Read full story Source: The Guardian, 29 September 2026 Related reading on the hub: Creon shortages: “It’s just another thing patients with cystic fibrosis could do without” Medication supply issues: A pharmacist’s perspective Medicines shortages: minimising the impact on patients (a blog by Catherine Picton) -
Content Article
Healthcare professionals frequently collect patient safety data, but many lack the knowledge and structured processes needed to interpret these data and translate findings into meaningful improvement actions. This gap results in underutilised opportunities to identify risks, apply evidence-based interventions, engage interdisciplinary teams, and measure impact. Addressing this gap helps the healthcare team more effectively use data to guide patient safety and quality improvement efforts. In this recorded webinar from the Patient Safety Authority, Andrea Atkinson, BSHCA, RRT, director of quality management; Christy Kitta, BSN, RN, quality and patient safety officer; and Ziad Dimachkie, MD, chief medical officer, all from Uniontown Hospital: Describe how patient safety data could be transformed into actionable insights to improve patient safety outcomes. Identify key sources of patient safety data and explained how each contributed to understanding safety gaps. Recognize strategies for engaging interdisciplinary teams and leadership in data‑informed patient safety improvement efforts. -
Content Article
The Sick List is a range of practical guides, made by patients, to help hospital stays, treatment days and recovery at home more comfortable and less stressful. The guides covers things from what eye masks help to actually block out hospital lights, to toiletries that will protect your dignity, to the random things no one tells you to pack in your bag but make a huge difference. If you're a patient about to go into hospital, or you know someone who is and would like to support them practically, this resource can really help. -
Content Article
Dominic Shadbolt, founder of PatientSignal and an multiple sclerosis (MS) patient of 35 years, has published a number of blogs on his Substack on AI in healthcare. -
Content Article
In this blog for the Parliamentary and Health Service Ombudsman, Paula Sussex writes about World Patient Safety Day. She says it is an opportunity to reflect on how we can make healthcare safer for everyone, and the importance of meaningful engagement with patients and families throughout their healthcare journey. -
News article
NHS England’s patient safety chief has said the service is having to “battle against a narrative” that it has not improved safety. Aidan Fowler, NHSE’s national director for patient safety, told HSJ’s Patient Safety Congress in Telford today that the narrative, which he described as “really challenging”, “sometimes says we haven’t made progress on patient safety when we know we have”. He said ministers had “understandably” wanted to suggest “everything that happened [during] the last government was terrible, and that includes some of the work that people here have done”. Dr Fowler said there “has been progress”, but this meant they “have to keep restating that, making the argument again”, which could “feel like quite hard work”. The NHS Patient Safety Strategy was launched in 2019, and the new NHS quality strategy published this summer suggested it would need another refresh in the near future. Dr Fowler admitted that some of this work, which has included changing the way the NHS responds to incidents through the Patient Safety Incident Response Framework, “is not very sexy”, so people have not heard about it. He added: “I get that if you try and explain to all our patients what PSIRF is, they’re going to struggle with [it], I understand that. “But I think that stuff has been foundational and important. We’ve created some bits of work that I think are really important, and we have made a difference.” The national director also stressed there was “of course much more to do”, and that improvement was a “continuous process”. Read full story (paywalled) Source: HSJ, 28 September 2026 -
Content Article
Is integrated patient experience intelligence finally possible in the NHS? Or will infrastructure without design leave us with expensive technology and limited value? For years, patient feedback has existed in frustrating fragmentation. Complaints sit in one system, surveys in another, Friends and Family Test (FFT) scores somewhere else entirely. All sit in a different system. None connected. No one recognises the patterns until harm has occurred. The infrastructure pieces needed to solve this are forming. The NHS Federated Data Platform (FDP) is operational. The NHS App is expanding. Patient Reported Experience Measures (PROMS) are being designed and validated. Large language models (LLMs) are proving capable of analysing unstructured feedback at scale. However, having these pieces available does not deliver integrated patient experience intelligence. That requires deliberate strategic design: decisions about what capabilities to build, data architecture purpose-fit for those outcomes, governance frameworks enabling appropriate uses, sophisticated analytical infrastructure, organisational change and sustained commitment. Ben Kenyon examines it all in this three-part series: Part 1 examines where we are today: the fragmentation challenge, why feedback sources don't connect and the safety signals we're losing as a result. Part 2 explores the infrastructure pieces now coming together: the FDP, NHS App and LLMs, and why deployment alone won't deliver integration. Part 3 shows -
Content Article
This guide from Taluvu looks at how to prepare for a GP appointment when there is a lot to explain. It covers: choosing the three things you would hate to forget gathering what you already know writing it down before you go rather than in the waiting room what to say in the first minute what to do if the words go and what to ask before you leave the room. Last week
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EventHealthcare is delivered through complex and constantly changing systems. Staff make difficult decisions while managing high workloads, interruptions, time pressures, new technology and competing demands. Human factors enables organisations to examine how these conditions interact with people, tasks, equipment, environments and organisational processes — and to redesign care so that safe practice is supported rather than dependent on individuals overcoming weaknesses within the system. The conference will also consider the growing human factors implications of electronic patient records, automation, ambient documentation and artificial intelligence. While digital technology can improve safety, productivity and access to information, poor usability, alert fatigue, automation bias and disrupted workflows can introduce new risks. Safe implementation requires technology to be designed around patients and staff, with frontline users involved in its design, testing and evaluation. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/a-practical-guide-to-human-factors-in-healthcare or email [email protected]. Follow the conference on X @HCUK_Clare #HumanFactors hub members receive a 20% discount. Email [email protected] for discount code.
