National State of Patient Safety 2024: Prioritising improvement efforts in a system under stress (12 December 2024)

Summary

This report presents the national state of patient safety in England in 2024. Two years on from their first report, the authors provide an updated analysis of the publicly available data. The report concludes that performance in key areas such as maternity care has deteriorated, requiring urgent attention. This report was produced by Imperial College London's Institute of Global Health Innovation in partnership with the charity Patient Safety Watch.

Content

Key figures highlighted in this report include:

• In 2023, the number of deaths that could have been avoided if the UK matched the top 10% of Organisation for Economic Co-operation and Development (OECD) countries was 13,495.
• In 2023, the UK ranked 21st out of 38 OECD countries for patient safety.
• Cost of harm for claims resulting from incidents in 2023/24 was £5.1 billion.
• Maternal deaths increased from 8.8 to 13.4 per 100,000 maternities between the 2017-2019 and 2020-2022 periods – an increase of 52.3%.
• In 2023, the proportion of patients who said there were enough nurses on duty to care for them was 56%.
• As of September 2024, the proportion of people waiting more than four hours for a treatment decision in A&E was 25%.
• In 2023, 65% of maternity units in England were rated as “inadequate” or “requires improvement” for safety by the Care Quality Commission.
• In June 2024, the number of people waiting for elective care was 7.6 million.
• 2 in 3 staff feel unable to carry out their jobs fully due to workforce shortages.

The report sets out two recommendations to support the long-term improvement of patient safety in England:

1. Local NHS organisations must be supported to adopt evidence-based interventions to tackle the most common safety problems causing significant harm to patients. The report’s analysis of trust patient safety plans identified six common problems that many organisations are tackling, such as pressure ulcers and patient falls. Adopting proven interventions to common problems like these would finally see the NHS truly acting like a National Health Service. The authors envisage a future where the first port of call for NHS organisations is a repository of such interventions, along with the support they need to implement them, rather than developing their own solutions from scratch.
2. National organisations must agree on a focused set of patient safety improvement priorities for the system to rally around. The report’s analysis found a crowded landscape of patient safety bodies, an opaque process for national priority setting, and evidence that the system cannot keep pace with the volume of recommendations it receives. The authors envisage a future where patients and healthcare workers are partners in the development of these priorities, and where national organisations rationalise their own activities to ensure the NHS is supported to deliver improvements against them.