The King’s Speech 2026: Six key takeaways for patient safety (Patient Safety Learning)

Summary

The King’s Speech 2026 sets out the programme of legislation that the UK Government intends to pursue in its next parliamentary session. This blog highlights six key takeaways from this speech from a patient safety perspective.

Content

On Wednesday 13 May 2026, Kings Charles III delivered his annual speech in the Lords Chamber at the State Opening of Parliament.[1] Written by the Government and delivered by the Monarch, the speech presents opportunity at the start of a new parliamentary session for a government to set out its plans for the year ahead.

This year’s speech includes two pieces of proposed legislation that have, potentially, significant implications for patient safety:

• NHS Modernisation Bill
• Public Office (Accountability) Bill

In this blog, we highlight six takeaways from these proposed bills from a patient safety perspective.

1. Future of the Health Services Safety Investigations Body

The NHS Modernisation Bill includes several changes to the patient safety landscape in England. These involve the implementation of several key recommendations put forward in Dr Penny Dash’s Review of patient safety across the health and care landscape last year.[2] This includes the recommendation to transfer the Health Services Safety Investigations Body (HSSIB) functions to the Care Quality Commission (CQC).

In our response to the Dash Review, we stated our belief that HSSIB has an important independent role in the health system which should be retained.[3] There are understandable concerns about the potential for its independence to be compromised by its functions being transferred to the CQC.[4] [5]

More broadly, we know that many staff working in healthcare do not feel confident raising concerns. As NHS Staff Survey results continue to illustrate, nearly two-fifths of staff say they do not feel safe to speak up about concerns.[6] Recognising the importance of staff feeling able to speak freely in investigations, HSSIB currently conducts these using a ‘safe space’ approach. This prohibits, on a legal basis, the unauthorised disclosure of protected material. Even if this legal assurance is maintained under these proposed changes, there still may be concerns that moving HSSIB into the CQC could potentially undermine staff confidence that confidentiality will be maintained.

If confidence in the independence and confidentiality of HSSIB’s investigations is undermined, whether in reality or perception, this could compromise understanding of what is really happening on the ground. HSSIB’s ability to do this is an essential prerequisite to understand what the risks to patient safety are and the action needed to address these.

We await further detail in the NHS Modernisation Bill on how these challenges will be addressed.

2. Embedding patient voice in national decision making

Other notable recommendations from Dr Penny Dash’s review expected to feature in the NHS Modernisation Bill include:

• Transferring the functions of Healthwatch England to the Department of Health and Social Care.
• Developing a new Patient Experience Directorate in the Department.

In our response to the Dash Review, we welcomed the proposal to create a new National Director of Patient Experience, alongside a Patient Experience Directorate. A new central body offers potential benefits for pooling expertise and resources. However, questions remain as to whether these changes could risk making the routes through which patient experience and concerns influence decision making less visible and more diffuse.[7] [8] [9] [10]

It is vital that these changes improve the health systems capacity to listen and respond to patient experiences. We believe that an important element of this will be ensuring this new Patient Experience Directorate can benefit from regional and local experience and expertise. We would expect to see further detail setting this out in due course, considering how this will connect with local models for engaging with patients, families and carers.

Specifically, we would also seek clarity on how this Directorate will work with local and national Patient Safety Partners, whose roles were not mentioned in the Dash Review.

3. Creating a new single patient record

Another key strand of the NHS Modernisation Bill will be plans to create a new Single Patient Record. This is intended to “enable people to see their own health records securely on the NHS App, empowering them to make informed decisions about their own health”.[11]

In our response to the 10 Year Health Plan for England, we stated our support for this initiative.[12] It is broadly acknowledged that if implemented effectively, this could make a real difference in improving joined-up communication in the NHS.[13]

Patients not only need easy access to their records, but simple mechanisms to flag concerns and address any inaccuracies in a timely manner. Mistakes in records can create significant patient safety risks, and as illustrated by patient experiences shared with us on our patient safety platform the hub, amending these is often not a simple process.[14]

4. Introducing the Hillsborough Law

The proposed Public Office (Accountability) Bill would put in place a new professional and legal Duty of Candour—meaning public officials must act with honesty and integrity at all times. This was previously announced in September 2025 and the Bill itself has already been tabled in Parliament.[15]

We welcome this legislation. Patient Safety Learning believes it should be a requirement to be honest and transparent with patients and their families when something goes wrong, and this should be fundamental for all staff. 

The proposals in this new legislation have greater scope than the existing statutory Duty of Candour in the NHS, with a focus on systemic institutional behaviour. It is also notable that these provisions of the Bill will apply to the whole of the UK, not just England and Wales.

5. Abolition of NHS England

The NHS Modernisation Bill will legislate to integrate NHS England’s functions into the Department of Health and Social Care, as first announced last year.[16]

While we are still waiting further detail of what this will look like in practice, the existing National Patient Safety Team at NHS England is likely to be impacted by these changes. This Team is currently responsible for owning various patient safety programmes and policies and issuing safety warnings and recommendations.

As stated in our response to the 10 Year Health Plan for England, an area of concern for us remains the lack of significant capacity to intervene if necessary for the purposes of improvement at a national level. Alongside this, there is also currently no national body able to commission or develop solutions that all organisations can use and adapt to improve patient safety.

If healthcare providers identify a systemic issue that needs to be addressed because it affects other organisations, there is no national organisation that has the role or capacity to act on this. Instead, providers are left to find local solutions to system-wide concerns without a vehicle for widespread dissemination and evaluation.

We believe this gap places a serious limitation on the healthcare system’s ability to reduce avoidable harm. It does little to address the inconsistencies in care across the country, with multiple different responses and workarounds to system-wide problems with varying levels of success. It is also a significant missed opportunity if we fail to take learning gained from provider organisations and apply this nationally for improvement in a meaningful way.

This is an issue we think should be considered and addressed in the future merger of NHS England and the Department of Health and Social Care.

6. Changes to Integrated Care Boards

Finally, the NHS Modernisation Bill will also include several changes for Integrated Care Boards (ICBs), including:

• Refine the membership of ICBs.
• Placing new requirements for mayoral nominees to be on ICBs.
• Confirming their role as strategic commissioners, by transferring responsibilities for all but the most specialised commissioning functions to ICBs.

In a joint blog with the Advancing Quality Alliance (Aqua) earlier this year, we noted that there is huge opportunity for ICBs to drive a systemic approach to patient safety through their strategic commissioning responsibilities.[17] [18] [19] However, there is currently significant variation in ICBs involvement in safety management activities.[13]

With the right support ICBs have the potential to develop an integrated and coordinated approach to safety, reflecting patient care pathways across systems and ensuring consistency and collaboration. We would hope to see this included in these changes considered in the provisions of the NHS Modernisation Bill, and in the forthcoming new NHS Quality Strategy.

References

1. Prime Minister’s Office. 10 Downing Street. Oral statement to Parliament: The King’s Speech 2026. 13 May 2026.
2. Department of Health and Social Care. Review of patient safety across the health and care landscape. 7 July 2025.
3. Patient Safety Learning. Review of patient safety across the health and care landscape: Patient Safety Learning‘s response. 15 July 2025.
4. Macrae C. Failing to learn? The NHS is losing its capacity for system-wide safety investigation. Journal of the Royal Society of Medicine, 2025; 118(10).
5. Health Service Journal. Merging watchdog into CQC will ‘destroy’ independence. 26 February 2026.
6. Patient Safety Learning. Patient Safety Learning’s response to the NHS Staff Survey Results 2025. 13 March 2026.
7. Martin G, O’Hara J. Hope over experience? Patient and staff voice in the NHS after the Dash review. 1 2025;390:r1514.
8. Cox C. Is the patient voice fading? Reflections on patient safety in a changing NHS. Patient Safety Learning. 28 January 2026.
9. Morris L, et al. The Kings Fund. The future of patient voice: learning from the Healthwatch model. 18 March 2026.
10. Patient Safety Learning. Patient voice, safety and the NHS 10 Year Plan: Reflections from the Patient Safety Forum 2026. 23 March 2026.
11. Prime Minister’s Office. 10 Downing Street. King’s Speech 2026: background briefing notes. 13 May 2026.
12. Patient Safety Learning. 10 Year Health Plan: Patient Safety Learning’s response. 14 August 2025.
13. The Kings Fund. The King’s Fund responds to the King’s Speech and the introduction of the NHS Modernisation Bill. 13 May 2026.
14. Anonymous. The digitalising of patient records – why patients MUST be involved. Patient Safety Learning. 16 April 2024.
15. House of Commons. Public Office (Accountability Bill), Session 2024-26. Last updated 5 May 2026.
16. Department of Health and Social Care. World’s largest quango scrapped under reforms to put patients first. 13 March 2025.
17. Patient Safety Learning and Aqua. Patient safety and the new NHS Quality Strategy. 25 February 2026.
18. Aqua. What Should Safety Look Like at a System Level. 6 April 2023.
19. Patient Safety Learning. The elephant in the room: Patient safety and integrated carer systems. 11 July 2023.
20. Health Services Safety Investigations Body. Safety management: accountability across organisational boundaries. 13 February 2025.