10 Year Health Plan: Patient Safety Learning’s response (14 August 2025)

Summary

On 3 July 2025, the UK Government published its 10 Year Health Plan for England. The Plan sets out how it intends to create a modern health service designed to meet the changing needs of the population. This article sets out Patient Safety Learning’s response to the Plan.

Content

In our initial reflections on the 10 Year Health Plan, we highlighted that although it  disappointingly does not recognise patient safety as one of its core themes, it does set out a welcome ambition to tackle some of the key underlying causes of avoidable harm.

In this response, we seek to elaborate this in more detail, setting out why patient safety needs to be at the core of the delivery of this new Plan. Much of the focus of our response concerns two of its three radical shifts: “Hospital to community” and “Analogue to digital”. We have not considered “Sickness to prevention” in detail, in recognition that many of the key aspects of this, such as legislative changes around the sale of tobacco and restrictions on junk food advertising, fall outside of our charity’s focus on patient safety.

We would not claim to have all the answers on how to ensure patient safety is designed into a new future vision of the NHS. Indeed, much of this will need to wait to be informed by the delivery plans that the healthcare system will be developing. We will respond on these issues as greater detail emerges.

Many of the issues we identify have been relevant for many years as the NHS has responded to other visions, plans and responses to inquiries into serious avoidable patient harm. Collectively, we should challenge ourselves to ask: Will it be different this time? Will the knowledge of the causes and contributory factors of avoidable harm be recognised and action taken to prevent future patient safety tragedies? Can we move from saying “never again” to making sure that lessons really are learned and action taken?

Key messages

You can read Patient Safety Learning’s full response to the Plan here. Below is a summary of our key messages that run through this response: 

• We are disappointed that the 10 Year Health Plan does not identify patient safety as a key theme in delivering the three radical shifts in the NHS. We believe the risk and impact of avoidable harm to patients should be recognised as a strong driver of change. Patient safety is not just another priority; it should be a core purpose of health and care.
• Avoidable harm continues to persist at an unacceptable level. Every avoidable death and disability is an unnecessary tragedy for patients, families and healthcare professionals. It also comes at a huge financial cost. We must prevent avoidable harm to both reduce suffering and ensure funds are spent on services and not the associated enormous cost of unsafe care.
• There are not yet published delivery plans to go with this vision for the future of the NHS. Without these it is difficult to assess whether the 10 Year Health Plan’s ambition is likely to be realised and the significant and all too familiar patient safety concerns are addressed.
• Creating a Neighbourhood Health Service is an admirable ambition. It is a significant undertaking, and service redesign and plans should ensure that patient and staff safety is core to how care is delivered, how unnecessary hospital admission is prevented and early discharge is supported. Safety should not be an afterthought.
• If the NHS is to become a fully digitally enabled service, patient safety will need to be at the heart of the introduction, implementation and operationalisation of new technologies and innovations, particularly AI-enabled care.
• Cyber attacks present a significant risk to patient safety; one which will only grow with the increased digitalisation of health services. The absence of digital security from the 10 Year Health Plan is a serious omission; planning and investment in this area will be essential to its successful implementation.
• We welcome the Plan’s ambition to make greater use of the NHS’s data to improve services and we agree that there needs to be significant investment in digital and data capacity. However, we would note that a key problem remains: “the implementation gap”. Even with the best data available, for any such system to be effective it must be matched by the appropriate mechanisms to act on its findings and subsequently check that these actions result in improvement.
• The Plan places a welcome emphasis on the importance of patient feedback and complaints, and the NHS App can undoubtedly be valuable here. However, we think there is important to acknowledge there is still an important a role for other sources of feedback, beyond an updated NHS App. This is particularly the case when it comes to patient safety concerns or poor patient experiences. Valuable learning and insights of this type can come from both inside and outside formal NHS processes.
• A strong emphasis is placed on patient choice in the Plan, but relatively little is said about the role of patient and public involvement in shaping healthcare services—beyond engagement through new digital portals. Coupled with the proposed centralisation of patient experience functions within the Department of Health and Social Care there are valid concerns this could act to weaken the strength and independence of the patient voice.
• The absence of considering and responding to problems with NHS culture is a significant oversight in the 10 Year Health Plan. One that, in our view, could jeopardise its delivery. Too often, at a national level, it appears that the extent and persistence of blame cultures in healthcare, and the need to tackle this, are simply not acknowledged. If the healthcare system is to truly be transformed over the next decade, then we cannot simply proceed by ignoring these issues or assuming they will resolve themselves.
• Coinciding with Dr Penny Dash’s review of patient safety, we welcome the overarching recognition of the need to coordinate and rationalise the patient safety landscape in England.
• However, the proposed structural changes do not address the ongoing patient safety “implementation gap”. They also do not tackle the absence of systematic approaches to sharing learning about avoidable harm, the inadequacy of joined up approaches and user-centred design in solution development. We need improvement action in the NHS at local and national levels to ensure that causes and contributory factors of avoidable harm are not just better understood but acted upon to prevent future tragedies.