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An integrated quality report (IQR or IQPR) connects clinical quality, experience, workforce, operations, risk and improvement. It is not every metric in one pack; it helps teams and boards judge whether services are safe, effective, caring, responsive and well-led, where assurance is limited and what must happen next. In this article, GGi senior consultant James Avery asks what constitutes a good integrated quality report. The article explores how: Good quality reports turn data into insight that drives change. Triangulated evidence explains not just what changed, but why. Insight must reach the frontline teams who can act. A seven-step test and maturity matrix shows where to improve.

The government has committed to reform of the scheme that provides financial support for those injured or bereaved by vaccines. It was a key recommendation of the UK Covid Inquiry, and has been a focus for campaigners. One campaign group has welcomed the recognition that vaccine injury and bereavement is real and that the current scheme is not fit for purpose. But it says it wants a clear commitment to action by ministers, rather than simply saying they will look further at what needs to be done. The benefits of vaccination are well documented. The AstraZeneca Covid jab is credited with saving millions of lives worldwide. But some people have experienced harm. In her fourth report, the chair of the Covid Inquiry, Baroness Hallett, called for better support for those affected. More than 24,000 people have made Covid-related claims to the Vaccine Damage Payment Scheme (VDPS), a form of financial support paid by the government, but just over 1% have resulted in one-off tax-free awards of £120,000. The report called for "urgent" reform of the scheme, saying that it is "not sufficiently supportive". One of the main campaign groups for those who were injured by the Covid vaccine is Vaccine Injured and Bereaved UK. The group welcomed the government's acknowledgement that vaccine injury and bereavement were real and that the VDPS is not fit for purpose. But in a statement it said that was not the same as committing to action. "After more than five years of campaigning, and with the Covid-19 Inquiry explicitly calling for reform as soon as possible, we had hoped the Government would finally come forward with a clear commitment to action, not simply say it would look further at what needs to be done. "We understand that work may be needed to develop the reforms, but there is a real difference between saying you will look at something and committing to deliver it. "Today, we have no clear timetable, no certainty about what will change and no assurance about when families will finally see meaningful progress." Read full story Source: BBC News, 16 October 2026 Related reading on the hub: UK Covid-19 Inquiry: Module 4 -Vaccines and therapeutics Adverse reactions to Covid-19 vaccination - are adverse reactions adequately understood and are patients affected provided for in your area? Interview with Charlet Crichton, founder of UKCVFamily

Bosses at a trust being investigated for corporate manslaughter have been criticised by a regulator, which found care and patient dignity failings, and a “disconnect” between senior leaders and frontline staff at its high-secure hospital. Rampton High-Secure Hospital, run by Nottinghamshire Healthcare Foundation Trust, was rated “requires improvement” again, following four inspections in April 2026 by the Care Quality Commission. The news follows a criminal inquiry being launched this summer into the trust’s care and treatment of Valdo Calocane, who killed Barnaby Webber, Grace O’Malley-Kumar, and Ian Coates in June 2023. The CQC said that while inspectors found some improvements had been made, they uncovered a series of managerial and care failings in staffing, safe care and treatment, dignity and respect, person-centred care, and in premises and overall management at the hospital. The report said: “We identified a disconnect between senior leaders and frontline staff regarding the rationale for some operational decisions and the day-to-day reality of staffing pressures.” The CQC was “not assured that senior leaders had acted effectively on feedback from previous assessments, as many of the concerns remained”, and staff who spoke up “had not seen meaningful changes as a result”. Read full story (paywalled) Source: HSJ, 21 October 2026

The Witness to Harm project has published a range of resources to support patients, families, colleagues and members of the public involved in fitness to practise proceedings. Developed from mixed-methods research into people’s experiences of taking part in hearings, the resources aim to improve understanding of the process and help people feel better prepared. They include a short film on what to expect before, during and after a hearing, alongside animations, information about the research and links to further support.

The Care Quality Commission (CQC) is examining the circumstances surrounding the death of a patient at a psychiatric hospital in Birmingham. Poppie Rogers, 22, died in June last year after taking a poisonous substance she ordered online while on the Larimar ward, an acute inpatient ward run by Birmingham and Solihull Mental Health Foundation Trust. The CQC told HSJ it is looking into the case and gathering information, including from the provider, so that it can determine whether any further action is required. The incident is referred to in BSMHFT board papers from earlier this year, which cited a “risk that patients may bring in or have delivered to wards harmful products leading to a risk of serious harm to themselves, other patients, or staff”. The papers said the risk was identified “following a serious incident where a patient was able to have a poisonous substance delivered in a parcel and ingest it, leading to their death. When the parcel was delivered to the ward, it was not checked by staff.” Read full story (paywalled) Source: HSJ, 20 October 2026

Only properly trained professionals will be allowed to offer high-risk cosmetic procedures like liquid Brazilian butt lifts (BBLs), vampire facials and chemical peels, under long-awaited government plans for England in 2027. The government said it wanted to "drive cosmetic cowboys out of the market" and shield people from treatments "that can go badly wrong". Currently, there are no restrictions over who can carry out these 'no scalpel' procedures, which can harm or kill if not performed safely. Under the new rules, high-risk procedures for under-18s will also be banned, and rogue providers will face new criminal offences and fixed fines of up to £4,000. It comes following horror stories of procedures reportedly carried out in Airbnbs, hotel rooms, garden sheds and even public toilets, by "cosmetic cowboys". Alice Webb, a mother-of-five from Gloucestershire, died within hours of getting a liquid Brazilian butt lift in 2024. That same year, Sasha Dean, from Bedfordshire, was left in a coma after receiving a liquid BBL. A BBL is a non-surgical cosmetic procedure in which dermal fillers are injected into the buttocks to alter their size or shape. Some of Sasha's treatment took place in a private house and she ended up developing sepsis. She told BBC News: "Very quickly it turned into a complete nightmare. "I had a heart attack, one of my lungs had collapsed, my kidneys were failing. My body was just completely shutting down." Read full story Source: BBC News, 21 October 2026

A baby girl who died from meningitis might have been saved if doctors had tested her for the infection sooner, rather than putting her symptoms down to Covid, an inquest jury has found. Five-month-old Esta High died at Leeds General Infirmary in November 2023, days after she was taken into the emergency department with a high temperature and vomiting. She had tested positive for coronavirus, and so opportunities were missed when doctors stuck with a diagnosis of Covid, the inquest found. Esta died from streptococcus pneumoniae meningitis, and her parents Lynsey Carr and Leon High told the inquest that doctors had missed vital chances to test for a bacterial infection and start vital antibiotic treatment. Carr told the inquest, at Wakefield coroner’s court, that their concerns were ignored until it was too late. Carr said she and her partner had refused advice from doctors to take Esta home, as she would not stop vomiting and had a temperature of over 40C. She said her daughter developed a rash and her arm started shaking, which she feared was a seizure. She told the jury “we were extremely worried” and “kept asking for help”, but “staff were rude and don’t listen to our concerns”. Carr told the inquest that the family, from Leeds, were put into a side room at the hospital’s children’s assessment and treatment (CAT) unit, adding that she believed staff were more concerned with isolating Esta due to the Covid risk than listening to her parents. She described Esta’s time on the CAT unit as “15 hours that were filled with missed opportunities”. “Unfortunately, as our daughter had been left untreated for 55 hours, it was too late to save our darling girl,” Carr told the inquest, describing her daughter as “bright, beautiful and perfect from the first moment”. Read full story Source: The Guardian, 20 October 2026

Government failures caused Covid-19 to spread “like wildfire” among vulnerable and elderly people, and Matt Hancock’s “protective ring” around care homes did not exist, a public inquiry has found. Heather Hallett, who is leading the Covid-19 inquiry, said the care sector was an “afterthought” and rejected the former health secretary’s long-held claim that he threw a “protective ring” around care homes from the start of the pandemic, saying it was “unfounded” and the “opposite was true”. She described the government’s failure to advise that patients discharged from hospitals into care homes should be isolated was a “significant omission”, which led the virus to spread rapidly among residents and staff. Lady Hallett also said preventing visits to care homes led to “immense emotional harm” for residents and left them with “profound isolation and a sense of abandonment”. “The adult social care sector as a whole appeared to be something of an afterthought, where the mantra of ‘protecting the NHS’ sometimes came at the expense of the users and providers of care,” she said. “Care homes received insufficient protection at the time they most needed it. These failures created environments in care settings in which the virus could spread like wildfire. “Most distressingly, some people were not permitted to be with their dying loved ones. Many remain racked by a guilt that they do not deserve to carry.” Read full story Source: The Guardian, 20 October 2026 Further reading on the hub: Questions around Government governance Covid Inquiry Recommendations Tracker (Covid-19 Bereaved Families for Justice)

Patients have been waiting up to a month for chemotherapy appointments because of staffing shortages, partly caused by reductions in bank rates. In August, patients at East Kent Hospitals University Foundation Trust waited three to four weeks for new patient and pre-chemotherapy appointments, leading to breaches of the 31-day standard. Board papers blamed “high levels of nursing vacancies” and said the August position was “due to lack of take-up of bank shifts due to NHSP [NHS Professionals] rate changes”. Trusts in Kent and Medway are now paying less for temporary shifts after two separate changes: one for nurses and other Agenda for Change staff, and one for doctors Read full story (paywalled) Source: HSJ, 20 October 2026

A former chief crown prosecutor has been appointed to chair England’s largest trust. Nazir Afzal will take up the role at Manchester University Foundation Trust on 4 January, succeeding Trevor Rees, who stepped in as acting chair after Kathy Cowell left to become regional chair for NHS England North West. Mr Afzal was previously a director at the Crown Prosecution Service in London, and served as the chief crown prosecutor for North West England from 2011 to 2015. He is also chancellor of Manchester University. He led an independent review into the Nursing and Midwifery Council in 2024, which found “dysfunctionality” “at virtually every level of the organisation, across all directorates”, alongside instances of bullying, racism, and discrimination. Mr Afzal said: “I intend to listen, to challenge when necessary and, above all, to keep patients and communities at the heart of what we do. “You cannot lead an organisation this important from a boardroom alone. I want to spend time with our teams, hear what is working and what isn’t, and make sure people feel able to speak openly. Good organisations are built on people who feel listened to and valued." Read full story Source: HSJ, 20 October 2026

Patient and Public Involvement and Engagement (PPIE) can bring valuable lived experience into decision-making, service improvement, research, and patient safety work. However, even well-intentioned organisations can make mistakes that reduce the impact of involvement and leave participants feeling undervalued. hub Topic leader, Aurora Todisco shares seven of the most common pitfalls and how to avoid them.

This study assesses the effects of an ambient artificial intelligence (AI) scribe on documentation time, note quality, clinician and patient experience in clinician–patient encounters. Using an ambient AI scribe for clinician-patient encounters reduces documentation burden, enhances clinician fulfilment and satisfaction and improves quality of interactions for patients. Effects of longer-term scribe use on professional efficiency and well-being, and patient care and outcomes warrant investigation.

The sixth module of the UK Covid-19 Inquiry examines the impact of the pandemic on the adult social care sector in England, Scotland, Wales and Northern Ireland. The module includes care provided in adult care and residential homes, in people’s own homes by professional carers and unpaid care provided by family members or friends. It looks at the decisions made by each nation’s government and considers: what happened to people living and working in the care sector during the pandemic how limiting visits to care homes affected residents and their loved ones how decisions to discharge patients to free up hospital beds affected those living and working in care homes. The module also examines the steps taken in care homes to stop the virus spreading and the care sector’s capacity to respond to the pandemic. Related reading on the hub: UK Covid-19 Inquiry Module 1: The resilience and preparedness of the United Kingdom Covid-19 Inquiry: Module 2, 2A, 2B, 2C Report – Core decision-making and political governance Covid-19 Inquiry: Module 3 Report – The impact of the Covid-19 pandemic on the healthcare systems of the United Kingdom UK Covid-19 Inquiry: Module 4 -Vaccines and therapeutics (16 April 2026) UK Covid-19 Inquiry: Module 5 – Procurement (14 July 2026) Questions around Government governance Covid Inquiry Recommendations Tracker (Covid-19 Bereaved Families for Justice)

Utah has become the first state in the US to allow artificial intelligence to issue new prescriptions and will soon do so without any initial medical involvement. US healthcare startup Nolla Health was authorised by the state to prescribe acne drugs earlier this month. The authorisation allows Nolla’s AI to prescribe drugs to adults in Utah who have mild to moderate acne after they have submitted their facial scans and medical information for the algorithm to review through the company’s Nolla Derm app. While every prescription will initially require a doctor’s approval, the AI will issue drugs independently in later phases of the trial. A company spokesperson told The BMJ, “Nolla remains in phase 1, requiring two Utah licensed doctors to review every prescription before it is issued. “The agreement lays out performance requirements and safeguards that must be met before we would consider progression to later phases.” The spokesperson added, “Nolla retains liability for its operations, participating doctors remain subject to applicable professional obligations, and patients retain their traditional legal remedies. The agreement with the state government requires adverse event reporting, immediate pauses for serious safety incidents, and ongoing state oversight. “Our office retains authority to terminate the pilot.” Read full story Source: BMJ, 19 October 2026

An NHS trust is being prosecuted over the deaths of two children who had sepsis, the BBC has learned. Two charges relate to Zadie Ajetunmobi, three, who died within hours of being taken to Broomfield Hospital, Essex, with a temperature of 40C (104F) in November 2022. A third regards two-year-old Selina Samarina, who was sent home by a doctor at Broomfield in April 2024, only to die two days later. Mid and South Essex NHS Foundation Trust (MSE), which runs the hospital, said it was "working closely" with investigators. It is due before Chelmsford Magistrates' Court in December. Care and treatment was allegedly "not provided in a safe way" to the girls, court documents revealed. The prosecution is being brought by the Care Quality Commission under the Health and Social Care Act. Zadie died within 10 hours of being taken to Broomfield on 10 November 2022, having suffered a cardiac arrest. A post-mortem examination showed her death arose from complications associated with sepsis, external. She was not given a potentially life-saving dose of intravenous antibiotics for more than seven hours. Zadie's family were previously told by MSE that staff had not updated local sepsis guidance since 2017. Read full story Source: BBC News, 20 October 2026

Emergency care doctors have warned the NHS is not ready for the colder months, with overcrowding, corridor care and a looming surge in demand “creating perfect conditions for a terrible winter”. A new survey of 163 doctors in charge of A&E departments across the UK, conducted by the Royal College of Emergency Medicine (RCEM), found that more than nine in 10 (92%) described current pressure as either high or very high, while 88 per cent said they are under greater strain now than this time a year ago. Around nine in 10 (91%) told the poll they were very or extremely worried about pressures in the coming months. And after A&Es in England saw a record 7.3 million people attending hospital for emergency care this summer, leading accident and emergency (A&E) doctors have said the NHS is at the point “where we can’t tell where one crisis ends and the next begins”. Three in five doctors have warned their A&E departments are currently unsafe for patients, with conditions expected to worsen after the UK experienced higher levels of flu last month compared with the previous four years. The RCEM also warned the NHS is entering this winter with almost a thousand fewer beds in English hospitals compared to last year. Read full story Source: The Independent, 20 October 2026

Doctors have developed an artificial intelligence tool that can predict a cancer patient’s chances of survival from a single photograph of their face. The AI system was custom-built by experts at Mass General Brigham, a nonprofit, integrated academic healthcare system in Massachusetts, to estimate biological age and directly predict survival outcomes in patients diagnosed with cancer. It is one of the most comprehensive demonstrations to date of how AI analysis of a selfie could help assess a patient’s health and potentially guide their medical care, and was trained on data from more than 40 million facial photographs across a range of ethnicities and ages. Details of the breakthrough were published in the Lancet Digital Health journal. The system can estimate a person’s biological age – the age a person looks, rather than their actual, chronological age – and predict the chances of survival for cancer patients from an ordinary photograph of their face, according to the results of a study that examined the model. “FAHR-FaceSurvival advances the field of facial health recognition AI a step further by learning survival risk directly from facial photographs of patients with cancer,” said Hugo Aerts, a co-senior author of the study. “To our knowledge, this is the first demonstration that an AI model can directly predict cancer survival from a simple photograph.” Read full story Source: The Guardian, 19 October 2026

The death of a man being cared for on a virtual ward was the result of a “catalogue of failings” by two trusts, a coroner has ruled. Tony Hornby died from pneumonia on 21 December last year while under the care of a virtual ward service from Mersey Care Foundation Trust and East Cheshire Trust. Coroner Victoria Davies found that the “catalogue of failings” which contributed to the death of 71-year-old Mr Hornby could “be summarised as: an abject failure to recognise a deteriorating patient despite clear objective evidence from observations, a complete lack of professional curiosity by those who were aware of the observations… a breakdown in communication of the abnormal results, a failure to make a plan when considering the abnormal results, and a failure to escalate for action to be taken”. The inquest ruled that readings recorded while he was on the virtual ward showed he should have been brought back to hospital days before his death. Ms Davies concluded that Mr Hornby had experienced a “series of gross failures to provide basic medical care” and his death was “due to natural causes contributed to by neglect”. Read full story (paywalled) Source: HSJ, 19 October 2026

Patient Safety Partners (PSPs) can be patients, relatives, carers or other members of the public who want to support and contribute to a healthcare organisation’s governance and management processes for patient safety. In this blog, Lea Tiernan, Patient safety engagement & involvement lead at Imperial College Healthcare NHS Trust, shares their approach to evaluating the impact of PSPs alongside a suite of related resources for others to adapt and use.

The Health Bill will shape how patients’ voices are heard in health and social care for years to come. On 8 October 2026, the Patients Association brought together patients, carers and representatives from national, local and community organisations to explore what independent patient voice needs to look like in practice. Participants were clear that being listened to is not enough. Patients need an independent voice that reaches decision-makers, leads to action and holds the system to account. This report sets out what independent patient voice means, seven principles that future arrangements must meet, and the messages decision-makers need to hear to ensure patients can influence decisions and see meaningful change.

New research commissioned by the Professional Standards Authority for Health and Social Care (PSA) reveals consumers spend almost as long researching a hotel stay as they do a private baby scan clinic, with 1 in 4 not considering safety checks when booking appointments. 'Look Before You Book’ is a PSA public awareness campaign, encouraging people to look for the Quality Mark to check that their practitioner is on an Accredited Register.   It focuses on counselling and psychotherapy, private baby scans (sonography) and non-surgical cosmetic procedures, helping consumers recognise the PSA Quality Mark and make safer choices when booking private health and wellbeing services. Their dedicated Look Before You Book campaign landing pages provide tailored information for people considering counselling and psychotherapy, private baby scans or non-surgical cosmetic procedures. Each page explains why it is important to check who you are booking and how the PSA Quality Mark can help you make a safer, more informed choice.

New safety measures are now being implemented for all patients taking antidepressant medications. This follows completion of a detailed review, involving patients and their families, into how the risks of suicidal thoughts and behaviours, and persistent sexual dysfunction are communicated in the patient information leaflets (PILs) that accompany antidepressant medications. These changes involve a new boxed warning in the PIL, a new patient card and a supporting safety (ancillary) leaflet. The term post SSRI sexual dysfunction ('PSSD') is also being added to the PIL for some antidepressant medications.

Trans people could face delays and a greater risk of “corridor care” under new NHS England guidance that means they will no longer be able to use same-sex wards, according to an internal report. An NHS England impact assessment, seen by the Guardian, stated that trans people may also potentially experience discrimination and this could lead to them “avoiding accessing healthcare at all”. The document considered the impact of new NHS guidance on single-sex spaces across all protected characteristics, including age, disability and sex. It said the policy’s focus on “privacy, dignity and safety for men and women” would have a positive impact, as would the legal accuracy in guidance on single-sex spaces. But it said there were a “number of potential adverse impacts for trans people”, adding: “There may be delays and a greater risk of ‘corridor care’ for trans people with a negative impact on their physical and mental health and wellbeing if side rooms are not available. “Trans people may fear and potentially experience discrimination by being ‘outed’ as trans through not being accommodated in a ward that aligns with their lived gender or being placed in a side room.” It said there was a risk that hospitals would not have the capacity to provide side rooms when needed, “forcing trans people into the potentially distressing situation of being accommodated on wards aligned with their biological sex”. Read full story Source: The Guardian, 18 October 2026

Up to 20 maternity units in England will have to shut to ensure mothers and babies receive safe care amid shortages of doctors and rising caesarean section rates, an NHS leader has warned. Matthew Hopkins, the NHS Alliance’s director for acute care, said centralising childbirth services into fewer hospitals was “inevitable” and the “right thing”, but would lead to a political backlash against unpopular changes. Ministers must “grasp the nettle” that as many as 20 of England’s 155 NHS units that are led by consultant obstetricians will need to shut or change their role, he added. Smaller maternity units that deliver only 1,500 to 2,000 babies a year are becoming increasingly unsustainable because of a widespread lack of obstetricians and a sharp rise in recent years in the number of women having either a planned or emergency caesarean section, he added. Many of the units most at risk are in rural or coastal areas, where staffing is particularly challenging, he told the Guardian. “We are calling for a thorough appraisal of maternity services and where they need to be located because the current configuration is not fit for purpose,” Hopkins said. “Difficult decisions lie ahead, consolidating maternity services to support safer, more sustainable care. “If politicians … are keen to see safe maternity services in their area, it is going to need courage to grasp the nettle that needs to be grasped in order to improve maternity services.” Read full story Source: The Guardian, 19 October 2026