Letter from Patient Safety Partners calls for fatigue to be added to organisational risk registers (20 January 2026)

Summary

On the 20 January 2026, a selection of Patient Safety Partners who are also members of the Patient Safety Partners Network, wrote to a number of key stakeholders outlining their concerns around healthcare worker fatigue and calling for action. 

The letter was sent to:

• Wes Streeting MP, Secretary of State for Health and Social Care
• Baroness Merron, Parliamentary Under-Secretary of State (with portfolio responsibility for patient safety)
• Dr Aiden Fowler, National Director of Patient Safety and NHS England
• Professor Henrieta Hughes, Patient Safety Commissioner for England
• Layla Moran MP, Chair of the Health and Social Care Select Committee
• Jeremy Hunt MP, Chair of the All-Party Parliamentary Group on Patient Safety
• Danny Mortimer, Chief Executive of NHS Employers

The content of the letter can be viewed below.

Content

20 January 2026

Dear [RECIPIENT]

We are writing to you on the issue of healthcare worker fatigue and its impact on patient safety.

The signatories of this letter are all members of the Patient Safety Partners Network. The Network is composed of Patient Safety Partners, in both paid and voluntary positions within NHS organisations, whose role is to improve patient safety. It is hosted on the hub by the charity Patient Safety Learning, who provide a monthly drop-in session, sometimes with guests, to talk through topical and relevant issues. This facilitates information sharing, peer support and safe space for discussion.

Fatigue poses serious risks to both the wellbeing of staff and safety of patients. Healthcare workloads are often heavy, stressful and involve complex decision making – however we lack robust fatigue risk management systems that exist in other safety-critical industries.

At a recent Network session focusing on fatigue, we were joined by Dr Laura Pickup, Head of Human Factors at University Hospitals Bristol and Weston NHS Foundation Trust and a member of the organising committee for the Healthcare Fatigue Forum. The discussion highlighted several key issues:

•  Fatigue in healthcare has become normalised, with staff continuing to work while exhausted, unlike in other safety-critical industries where controls are in place to prevent fatigue-related risks.
• Fatigue is a systemic issue, not an individual failing. It must be recognised through existing governance and risk management processes.
• Addressing fatigue requires leadership, organisational commitment, and system-level change, not simply individual resilience.
• Fatigue can be a contributor to avoidable harm and must be formally recognised as such within safety investigations.
• Staff should be empowered to speak up when they are too fatigued to work safely.

Our Call to Action

We are asking that every healthcare organisation formally adds fatigue to its organisational risk register.

By doing so, each organisation would be required to:

• Risk assess the impact of fatigue on both staff and patient safety.
• Identify mitigation and management actions to reduce fatigue-related risks.
• Monitor progress and outcomes through established governance systems.

Recognising fatigue in this way is not merely a procedural step—it is an essential act of leadership and accountability. It acknowledges that fatigue is a significant, system-level patient safety risk and ensures that it is managed with the same rigour as other high-impact safety concerns.

We would also welcome the following complementary actions:

• Inclusion of fatigue as a contributing factor in investigations under the Patient Safety Incident Response Framework (PSIRF), where relevant.
• Endorsement and amplification by the Department of Health and Social Care, NHS England, and individual NHS organisations of the work being done by the Healthcare Fatigue Forum and the #FightingFatigue campaign to raise awareness and share best practice.

We would welcome your response and support for our call to action.

I look forward to your response in due course.

Yours sincerely,

12 signatories were included (Members of the Patient Safety Partners Network).