Patient voice, safety and the NHS 10 Year Plan: Reflections from the Patient Safety Forum 2026

Summary

Last month, Public Policy Projects hosted their annual Patient Safety Forum in partnership with Patient Safety Learning. Held at the Royal College of Surgeons of England in London, it was attended by senior healthcare leaders, patient safety experts, representatives from the HealthTech industry, frontline healthcare professionals and patients. 

In this article Patient Safety Learning reflects on a discussion at this event between a panel of experts to discuss the ambitions set out in the NHS 10 Year Plan and what it means for patient voice and patient safety. At the heart of the discussion was a simple but important question: are patients truly at the centre of the system, and how do we make sure their voices lead to meaningful change?

Content

A positive shift towards patient choice

The NHS 10 Year Plan places strong emphasis on patient choice, agency and feedback. These commitments were widely welcomed by the panel. For many working in patient safety, the idea that patients should be central to their own care has long been a core principle.

Giving patients greater choice and making it easier for them to share their experiences is a positive step. It reflects years of calls for healthcare systems to listen more carefully to the people they serve.

However, some participants noted that, despite the focus on patient voice, patients themselves were not included on the panel. While there were patients on other panels during the conference, there was surprise that a patient safety partner or patient safety advocate had not been invited to contribute directly to the discussion. This absence highlighted a key tension: even when patient perspectives are recognised as vital, they are not always embedded in the decision-making or discussion processes themselves.

However, while the overall direction of travel is encouraging, the discussion also highlighted areas where the 10 Year Plan could go further.

What’s missing from the conversation?

Although the plan speaks clearly about choice and feedback, it is less explicit about patient innovation, co-production and the experiences of harmed patients.

These are crucial areas in patient safety. Patients and families often hold unique insights into where care has gone wrong and how it could be improved. When those perspectives are included early in improvement work, they can shape safer systems.

Panel members felt these aspects need clearer recognition if the ambition of truly patient-centred care is to be realised.

Trust, independence and the Dash Review

The conversation also touched on Dr Penny Dash’s review of the patient safety landscape, published last year, shortly after the 10 Year Plan. The review included a number of proposals with direct implications for the visibility and independence of patient voice at a national and system level. This included plans to bring patient feedback mechanisms “in house” within a new patient experience directorate and moving functions of Local Healthwatch into Integrated Care Boards and providers.

While this may improve efficiency, it raised concerns about independence and trust.

If feedback systems are managed solely by the organisations being complained about, patients and families may feel less safe raising concerns. Independence plays an important role in ensuring transparency and confidence that concerns will be taken seriously.

Maintaining that trust is essential if feedback is to remain open, honest and useful for learning.

Are patient experiences just “stories”?

Language became an unexpected but important theme.

Patient experiences are often referred to as “stories”. While this language can humanise healthcare and highlight the real impact of harm, the panel reflected on whether the term always serves patients well.

Referring to experiences as stories can unintentionally imply anecdote rather than evidence, potentially diminishing the seriousness of harm.

The panel was asked a simple question: which patient story has actually led to meaningful change?

When change only happens after escalation

Paula Sussex, the Parliamentary and Health Service Ombudsman (PHSO), shared an example of a complaint that reached Ombudsman level. In that case, input from both the patient and the organisation led to significant improvements.

It demonstrated the power of the patient voice when it is truly heard.

But it also raised an uncomfortable question: should change only happen once a complaint escalates to that level?

If meaningful improvements rely on escalation, it suggests earlier opportunities to listen and learn may have been missed.

A similar example was shared by Norma Findley from Seating Matters, who described how a large legal claim had acted as the catalyst for organisational change. Again, the discussion returned to the same point: should it really require litigation and serious harm before learning happens?

Too often, patient voices seem to gain traction only once they enter a formal or adversarial process.

A more proactive model in maternity safety

Louise Pye from the Maternity and Newborn Safety Investigations (MNSI) programme highlighted a different approach through their work around HEART and HEWS:

• HEWS: Health Equity Warning Score – this has been developed to classify a person’s risk of experiencing barriers to health equity.
• HEART: Health Equity Assessment and Resource Toolkit – this goes beyond HEWS and provides prompts and questions in relation to a person’s protected equality characteristics and social determinants.

By using HEART and HEWS, MNSI aim to ensure that their investigators make safety recommendations and prompts to NHS trusts that focus on health equity to ensure that they consider personalisation in all areas of maternity care.

Here, engagement with families is built into the investigative process from the beginning, rather than being added afterwards.

Louise suggested that healthcare needs a clear and consistent model for working with patients and families — one that is embedded, compassionate and applied across organisations.

The importance of co-production

Chris Graham from Picker emphasised the value of co-production and involving people with lived experience directly in improvement work.

Patient feedback can take many forms:

• Structured feedback
• Solicited surveys
• Systematic data collection

Each serves a different purpose. For example, feedback collected for regulatory assurance may be very different from feedback intended to inform service redesign.

Being clear about why feedback is collected makes it far more useful.

Complaints as a gift

Returning to the role of complaints, Paula Sussex explained how the PHSO analyses complaint data to identify recurring themes and systemic issues across healthcare.

She encouraged organisations to view complaints as a gift, an opportunity to learn and improve rather than something to fear.

For this to work, however, organisations must demonstrate visible change as a result of what they hear.

Listening alone is not enough.

Digital data and the risk of losing the human story

The panel also explored the growing role of digital analysis.

Large datasets can now be analysed quickly to identify patterns in patient feedback at scale. This can be powerful, helping organisations spot trends that might otherwise be missed.

But there is also a risk.

When experiences are reduced to coded data points, the emotional and relational context behind them can disappear. The challenge is to balance efficient analysis with preserving the human meaning behind patient experiences.

Learning from social media

Norma Findley also highlighted the potential value of social media communities, such as Facebook groups, as a source of patient feedback.

Increasingly, patients are sharing experiences outside formal healthcare channels. These spaces can offer valuable insights into patient concerns, expectations and emerging issues.

Used responsibly, they could help organisations become more responsive and transparent.

From listening to action

Across the discussion, one message came through clearly:

Patients want to be heard — but more importantly, they want to see change.

Acknowledging feedback is important, but what builds trust is demonstrable improvement.

Paula Sussex also noted that the statutory duty of candour, while well established in policy, is not yet fully embedded in practice. This reflects a broader challenge in healthcare: the gap between policy intentions and lived experience.

Key themes from the discussion

Several key themes emerged from the forum:

• Escalation as a catalyst for change - Improvements often occur only once complaints reach Ombudsman level or result in legal action.
• Independence and trust - Bringing feedback systems in-house could risk reducing perceived independence.
• Language and framing - The term “patient stories” can humanise experiences but may unintentionally minimise harm.
• Data versus narrative - Digital analysis offers scale but risks losing context if not balanced with human insight.
• Co-production and lived experience - Genuine partnership requires structured engagement with patients and families.
• From feedback to action - Patients want to see tangible improvement, not acknowledgement alone.
• The implementation gap - Commitments such as the duty of candour are still not consistently realised in practice.

A shared commitment to doing better

What stood out most from the discussion was a shared commitment to strengthening patient voice and patient safety.

The conversation recognised that progress has been made, but also that structural, cultural and linguistic shifts are still needed.

Rather than becoming influential only once harm has escalated into a formal complaint or legal process, the patient voice is most powerful when it is:

• embedded early in improvement work
• treated with respect and seriousness
• analysed thoughtfully
• and linked directly to visible change.

If the ambitions of the NHS 10 Year Plan are to be realised, ensuring that patient voices lead to meaningful improvement will remain one of the most important challenges ahead.

Share your insights

Have you seen the impact of the patient voice in patient safety? Share your thoughts on this article and the issues raised by commenting below (sign up first for free). Or you can email our editorial team at [email protected]. 

Find out more about the Patient Safety Forum 2026

You can read more about different discussions and panel sessions at this year’s event in the below:

• Designing AI with patient safety at its core: Reflections from the Patient Safety Forum 2026
• Safe systems, safe cultures: reflections from the Patient Safety Forum 2026