NHS patient safety strategy – progress update (July 2026)

Summary

This update highlights the significant achievements across the strategy’s national patient safety programmes.

Content

Early identification of deterioration (including Martha’s Rule)

• Implementation of Martha’s Rule began in May 2024 to give patients, families and staff a way to request a rapid review if they are worried their concerns about deterioration are not being addressed. It is now being implemented in all acute trusts in England for adult and children’s inpatient services, with pilots to roll-out to maternity and neonatal units, emergency departments, mental health and community settings under way.
• In its first year Martha’s Rule supported earlier intervention for more than 1,000 patients, including around 400 transfers to higher levels of care.
• A new early warning system for staff treating children launched November 2023. New tools have also been rolled out to manage early identification of deterioration in maternity and neonatal care including NEWTT2  which is now being used in over 90 Trusts, and MEWS used in over 65 Trusts.
• 1,621 care homes have been supported to identify deterioration, reducing 999 calls, emergency admissions and length of hospital stays. Modelling suggests if this work is scaled up across England, there is the potential for around 45,000 fewer emergency admissions and 485,000 fewer bed days in a 21-month period.

Maternity and neonatal care

• Over 1,900 neonatal lives saved through safer care bundle interventions, including improvements in optimal cord management and the administration of antenatal steroids.
• 600 fewer premature babies with cerebral palsy from the administration of magnesium sulphate during pre-term labour; the estimated saving in lifetime care costs is £600 million.

Medicines safety

• 1,900 deaths prevented through medicines safety initiatives
• £9 million has been saved in admission costs and further care costs avoided, due to harm reduction in relation to gastric bleeds, methotrexate overdose, opioid dependency, and drug induced Acute Kidney Injury (AKI).
• Since a dedicated improvement programme to reduce long term opioid use began in 2021, there are now 160,000 fewer people prescribed long term opioids than would have been if the trends from before the initiative continued. This equates to 16,000 harms avoided and 2,597 lives saved over the course of the programme. The reduced rates of opioid prescribing have been maintained since the programme concluded.
• The Valproate improvement programme has delivered major patient safety gains since 2018. Pregnancies exposed to valproate have fallen from 67 to just 2 in the equivalent six-month period (April to September 2018 versus April to September 2025), according to the Medicines in Pregnancy Registry. New prescribing for women aged 16–44 years has fallen by 77%, overall prescribing by 56%, and more than 8,500 women can now have a family without risks from valproate. Sodium valproate, while an effective treatment for epilepsy and bipolar disorder, carries a high teratogenic risk, with around 1 in 9 exposed pregnancies resulting in congenital malformations and up to 2 in 5 in neurodevelopmental disorders.

Transforming how we learn and respond to patient safety events.

Patient Safety Incident Response Framework (PSIRF)

• Patient Safety Incident Response Framework (PSIRF), a new national approach to incident response and investigation was launched in 2022, embedding systems thinking and improved engagement with patients, families and staff, and promoting a patient safety culture. The framework centres on maximising learning and patient safety improvement.
• It has been implemented in every NHS secondary care provider since 2024 and is now being piloted in 200+ GP practices with wider primary care scoping planned in 2027.

Learn from Patient Safety Events (LFPSE) service

• Learn from Patient Safety Events (LFPSE) service is the national NHS platform for recording and learning from patient safety events. In use across all NHS trusts in England since November 2024, it captures more than 3 million events each year.
• Next steps include using AI to improve data quality and insight, and publishing a Recorded Data Dashboard to support transparency, learning and targeted safety improvement.

National medical examiner system

• National medical examiner system became statutory in September 2024, meaning all deaths in England and Wales not subject to coroner inquiries now receive an independent review and bereaved families are offered a chance to speak to a medical examiner office. The National Medical Examiner’s Annual Report for 2025 highlights the system’s growing contribution to patient safety, providing real-time, independent identification of safety issues across care pathways.

Identifying and responding to patient safety risks

• The National Patient Safety Team’s statutory function to identify and act on emerging safety risks, includes issuing National Patient Safety Alerts and working in collaboration with partners on system wide action. It is estimated that annually this:
  - saves 160 lives
  - prevents 480 severe harm incidents
  - saves £13.5 million in treatment costs.

Building capability and capacity to address safety challenges

Patient safety leadership

• A Network of over 800 patient safety specialists has been created, providing expert patient safety leadership, guidance and support at NHS organisations across England.
• All patient safety specialists are offered in-depth training in patient safety.

Patient safety training and education

• The first National patient safety syllabus launched in 2022.
• Over 1.65 million completions of the essentials for patient safety’ training.
• Over 950,000 completions of the level 2 access to practice training for staff who want to understand more about patient safety or go on to access higher levels of training.
• Over 80,000 completions of bespoke level 1 training for NHS board members and senior leaders.
• Over 500 Patient Safety Specialists and other safety specialist roles such as Medicines Safety Officers and Medical Device Safety Officers trained in Level 3 and 4 of the Patient Safety Syllabus, delivered by Loughborough University. A second cohort for 2026/27 is in progress with a further 300 learners.
• 3,000+ digital clinical safety training completions.

Involving patients and the public in patient safety

• Framework for involving patients in patient safety published in 2021.
• Patient safety partner (PSP) role introduced to enhance the involvement of patients in patient safety work at a national and local level. Since 2025/26 it has been a  contractual requirement for NHS organisations to have PSPs on their safety governance committees.
• Patient Safety Partner Matters bulletin launched in 2024 to support PSPs in their role. The bulletin is nearing 1,000 subscribers.
• Simple steps to keep you safe during your hospital stay video and leaflet has been developed for patients.

Strengthening national patient safety systems

• Primary care patient safety strategy was published in September 2024 and added to the GP contract in April 2025. Implementation monitoring of Learn from Patient Safety Events (LFPSE) service is demonstrated in an increase of registered GP accounts to 64% by March 2026.
• Promoting openness, just culture and continuous improvement has included publication of the Being Fair tool in 2025, and Improving patient safety culture – a practical guide in 2023 – setting out approaches for NHS organisations to improve their patient safety culture.
• The Patient safety healthcare inequalities reduction framework published in 2025, sets out key principles to reduce patient safety healthcare inequalities across the NHS.

Digital clinical safety

• A Digital clinical safety strategy was published in September 2021.
• Continuation of Scan4Safety, an initiative supporting the introduction of barcode scanning technology to drive patient safety improvements.
• Ongoing national review of digital clinical risk management standards (DCB 0129 and DCB 0160) including a public consultation, to help ensure healthcare IT systems are safe for patient use.