Hope over experience? Patient and staff voice in the NHS after the Dash review (BMJ, 18 July 2025)

Summary

Penny Dash’s review of patient safety in England has recommended major changes to the organisational landscape. National bodies will be abolished or merged, and strategic planning and coordination is to be led by a newly reinvigorated National Quality Board. The Care Quality Commission (CQC) and the Department of Health and Social Care (DHSC) will take on some functions vacated by the agencies being disbanded, while at a local level, NHS trusts and integrated care boards (ICBs) will assume increased responsibility for managing, monitoring, and improving quality and safety, overseen by CQC.

The issues identified by Dash are real, and few will disagree with her assessment of the current environment. The response to patient safety problems has been the creation of multiple agencies with safety in their remit. They in turn have generated large numbers of poorly coordinated recommendations that represent a huge burden for NHS organisations. Scope creep has exacerbated the problem and Dash argues that attention to safety has come at the expense of other aspects of quality yet resulted in little tangible improvement.

In this BMJ opinion piece, Graham Martin and Jane O’Hara discuss the recommendations of the Dash review.

Further reading on the hub:

• Review of patient safety across the health and care landscape: Patient Safety Learning's response
• Suzette Woodward's opinion piece on the Patient Safety Review by Dr Penny Dash