NHS England: Patient safety healthcare inequalities reduction framework (15 May 2025)

Summary

This framework sets out 5 principles to reduce patient safety healthcare inequalities across the NHS. It outlines opportunities for implementation that local teams and Integrated Care Boards (ICBs) can take up, as well as the work NHS England is taking nationally to support and enable this. These principles align with the aims of NHS England’s Patient safety strategy and Core20PLUS5 approach for adults and for children and young people to address healthcare inequalities.

Content

Principle 1 – All staff, patients, service users, families and carers have access to information, translation and interpretation services when needed.

National actions:

• Publish a framework for community language, translation and interpretation.

Opportunities for local implementation:

• Improve every interaction between patients and healthcare staff.
• Make communication at all levels culturally and linguistically appropriate.
• Make information clear and accessible.
• Minimise the risk of digital exclusion.
• Reduce communication barriers.

Principle 2 – All healthcare staff receive undergraduate patient safety training, ongoing training, and accessible resources that improve their awareness and understanding of healthcare inequalities related to patient safety risks. 

National actions:

• Co-develop and publish a patient safety healthcare inequalities reduction handbook to provide guidance and ‘top tips’ for use by individual clinicians, organisations, patients and communities.

Opportunities for local implementation:

• Improve training.
• Develop a repository of accessible resources.

Principle 3 – Accurate and complete diversity data are collected for protected characteristics and inclusion health groups on digital platforms. This work includes making disaggregated data available so evaluation can drive improvements in patient safety and healthcare inequalities.

National actions:

• Clarify the requirements for reducing healthcare inequalities related to patient safety at the provider, ICB, regional, and national levels through the delivery of quality functions in the ICSs document on the ICS Quality Hub FutureNHS Collaboration Platform.
• Develop the LFPSE service to record the protected characteristics of those involved in patient safety events to identify when patient harm is more common in specific groups of patients, and whether there is case selection bias in patient safety incident investigations (PSIIs).

Opportunities for local implementation:

• Use data on health inequalities to improve safe care.

Principle 4 – Representatives of diverse communities are involved in the design and delivery of improvements aimed at reducing patient safety healthcare inequalities. This co-production involves drawing on the knowledge and experience of patients, service users, carers, families, communities and staff.

National actions:

• Promote the recruitment of diverse Patient safety partners (PSPs) and their value in co-production in all areas of patient safety improvement work by providing information, guidance, surveys and tools for support.

Opportunities for local implementation:

• Involve patients and diverse communities in developing patient safety improvements.

Principle 5 – Improve the understanding of patient safety healthcare inequalities and drive improvement through identifying priority areas for research.

National actions:

• Submit proposed patient safety healthcare inequalities reduction research questions to the next round of NIHR funding opportunities.

Opportunities for local implementation:

• Identify and enable research.