General practice

• There are 2,219 more salaried GPs* in September 2025 than in June 2024 (+20.5%). That monthly growth is almost 6x faster than Conservative governments achieved between 2015 and 2019.
• Between June 2024 and September 2025, the number of GP partners declined by 4.1% – and by 17.0% among partners under the age of 40.
• Though there are more GPs overall, the number of GP appointments has flatlined – meaning the number per GP was 2.7% lower in the 12 months to September 2025 compared to 2019.
• A record 8.6% of appointments in September 2025 were online, compared to just 0.7% in April 2023.
• But this is not widespread: three in 10 practices carried out no online appointments in the year to September 2025 (29.8%).

Hospitals

• Health spending growth is due to be only slightly higher than under the last Conservative government for the rest of this parliament (at 2.8% per year in real terms compared to 2.7%).
• 32 of 42 integrated care boards (76%) are forecasting a deficit in 2025/26, up from 18 in 2024/25.
• The growth of staffing has slowed since the start of 2024. There has been almost no change in the number of non-clinical staff in that time, while clinical staff have increased by 5%.
• Leaver rates have fallen to record lows (excluding the pandemic), with particularly low rates among consultants.
• In 2025 the NHS is recruiting more UK than overseas staff – reversing a trend seen between 2021 and the start of 2025, where more recruits came from overseas.

Of all reports, 96.0% came from hospitals, while 4.0% originated from nonhospital facilities (ambulatory surgical facilities (ASFs), birthing centres, and abortion facilities). The vast majority (96.0%) were incidents, while the remaining 4.0% were classified as serious events.

Preliminary 2024 reporting rates show 32.2 reports per 1,000 patient days for hospitals and 11.4 reports per 1,000 surgical encounters for ASFs, with both rates increasing by 1.1 points from 2023

Error Related to Procedure/Treatment/Test (P/T/T) remained the most frequently reported event type overall, accounting for 33.4% of reports from all facilities combined and 47.6% from nonhospital facilities. Among serious events, Complication of P/T/T was the most common type, making up 57.7% of serious event reports from all facilities combined and 71.4% from nonhospital facilities.

• Improvements in UK mortality rates slowed significantly in the 2010s, more than in most of the other countries studied. By 2023, the UK female mortality rate was 14% higher than the median of peer countries and the UK male mortality rate was 9% higher. For both, the gap to the median widened significantly after 2011, and the UK’s ranking relative to peer countries has now worsened.
• Improvements in mortality rates slowed across all UK nations and regions in the 2010s – but there are significant geographic inequalities. Scotland, Wales and Northern Ireland all have higher mortality rates than England. Scotland is performing particularly poorly – of the countries studied, in 2021 only the US had a worse mortality rate. In 2021, mortality rates were 20% higher in the North East and North West of England than in the South West.
• People aged 25–49 have seen a particularly pronounced relative worsening of mortality rates. In 2023, UK female mortality rates for this age group were 46% higher than the median of peer countries, while male rates were 31% higher. Of the other countries studied, only Canada and the US experienced a similar worsening of mortality rates among this age group over the 2010s. This worsening of mortality rates is a sign of ill health in the working-age population, acting as a drag on economic growth. 
• Of the main three causes of death for people aged 25–49, mortality rates for cancers and circulatory diseases improved between 2001 and 2019, but rates worsened for deaths from external causes. Deaths from external causes explain between 70% and 80% of the divergence in UK mortality rates compared with the median of peer countries over this period.
• While in the 2010s alcohol-related mortality rates for people aged 25–49 plateaued or declined and mortality rates for suicide (and undetermined intent) slightly increased, the rate of drug-related deaths rose sharply. In contrast, rates of drug-related deaths continued to decline for peer countries. As a result, the drug-related mortality rate in the UK was more than three times higher in 2019 than the median of peer countries.
• Geographic inequalities in drug-related deaths are stark among people aged 25–49. In 2019, the drug-related mortality rate in Scotland was around 4 times higher than in England. Within England, the drug-related mortality rate in the North East was 3.5 times higher for men and almost 4 times higher for women than in London.
• With the UK comparing poorly with many other high-income countries, improvement is both possible and urgently needed. This will require long-term action for economic recovery in areas of long run industrial decline; a strong focus on prevention; investment in public health services and action to address risk factors such as smoking, alcohol and poor diet; and a concerted effort to tackle drug-related deaths.
• These actions should be brought together in a clear strategy for tackling health inequalities. The UK government’s health mission promised just such an approach, but progress so far has been slow. This needs to change or the UK’s health will fall further behind its international peers. 

• In this survey 9.7% participants reported harm caused by the NHS in the last 3 years through treatment or care (6.2%) or the lack of access to care (3.5%). The main location where the harm first occurred was hospitals.
• A total of 37.6% of participants reported a moderate impact and 44.8% a severe impact of harm.
• The most common response to harm was to share their experience with others (67.1%). Almost 60% sought professional advice and support, with 11.6% contacting the Patient Advice and Liaison Service (PALS). Only 17% submitted a formal complaint, and 2.1% made a claim for financial compensation.
• People wanted treatment or care to redress the harm (44.4%) and an explanation (34.8%). Two-thirds of those making a complaint felt it was not handled well and approximately half were satisfied with PALS.
• Experiences and responses differed according to sex and age (eg, women reported more harm). People with long-term illness or disability, those in lower social grades, and people in other disadvantaged groups reported higher rates and more severe impact of harm.
• This study used a broader and more inclusive definition of harm and was conducted during the COVID-19 pandemic, making comparison to previous surveys challenging.

• This analysis presents the findings from the seventh wave of our public perceptions survey programme with Ipsos – and the first under the new Labour government. The survey into public perceptions of health and social care was conducted between 21 and 27 November 2024 with 2,198 UK adults aged 16 and older via Ipsos’ KnowledgePanel.
• Across the NHS and social care, the public is less negative and more optimistic about the performance of services than under the previous government, though perceptions are still largely negative overall. 21% think standards of NHS care will get better over the next 12 months, compared with 11% in May 2024. 11% think the standard of social care services will get better, compared with 5% in May 2024. The public is also more likely to agree the government has the right policies for the NHS than under the previous government, however still only 17% think this.
• For the first time in our polling series, the public’s top priority for the NHS is making it easier to get appointments at GP practices (38%). This is followed by improving waiting times for A&E (33%) and reducing the number of staff leaving the NHS by improving working conditions (29%). The public’s priorities have shifted since May 2024, with GP access, A&E waiting times and reducing waste and improving the efficiency moving up, while workforce issues have moved down.
• The majority of the English public is unaware of the government’s proposals for a National Care Service (76% unaware) and 10-Year Health Plan (73%). However, the ‘three shifts’ underpinning the government’s ideas for the 10-Year Health Plan are all well supported. The public is split on the trade-off between delivering social care reform quickly but potentially without cross-party consensus (40%) and building cross-party consensus, which may mean social care reform takes longer (43%).
• The NHS is the public’s top priority for extra public spending by a substantial margin. However, the public is divided about how, if at all, to pay for the extra spending needed to meet growing demand. While its preferred option is still to increase taxes to maintain the current level of care and services (42%), support for tax increases has fallen over time (down from 53% in November 2022).
• Labour won a landslide election victory, but the public mood on the NHS and care is more 'wait and see' than 'things can only get better'. The 10-Year Health Plan is a chance to change perceptions of the NHS and set a clear direction for the service. However, the government will need to articulate a more hopeful vision for the future and address the potential misalignment between their overriding political priority of reducing hospital waiting times and what is most important to the public.

• Real-terms increase in core local government spending power of around 3.2%, including £600 million of new grant funding to support social care (for both adults and children’s services) and a £86 million increase to the Disabled Facilities Grant.
• Total health spending increases by 3.8% a year on average in real terms between 2023/24 and 2025/26. This includes a 3.4% increase to day-to-day (resource) spending on items like staff salaries and medicines, and a 10.9% increase in capital investment on items like buildings and equipment over this period.
• Disincentivising activities that cause ill health by renewing and increasing duties on tobacco-related products and the Soft Drinks Levy.
• Increases to the National Living Wage and National Insurance Employer Contribution costs, which will particularly affect non-public sector employers.

The report revealed the following key findings:

• Not all patients have a ‘consumer mindset’ when navigating private healthcare. The report includes guidance to help both patients and the sector ensure that there is better communication, understanding and use of the choices that are distinctive to private healthcare.
• Patients’ private journeys are diverse because of their priorities and circumstances. So too their appetites for information, which can depend on their physical or emotional state, confidence in handling such information and previous experience in the private sector. 
• Participants told us there’s a lack of clarity and completeness in how private healthcare costs are represented, particularly the full set of in-hospital fees, as well as financing options. This prevents patients from making an informed choice and managing trade-offs. This was especially true for self-pay patients who felt that costs often seemed opaque, if not misleading.
• Patients told us that consultants should invest in their ‘shop windows,’ including participation in legally-mandated processes like PHIN and provide information that adds a human touch to their clinical information.
• The focus group participants liked PHIN’s website, neutrality and centrality in the sector, and felt it needed greater promotion; the majority had never heard of it before. However, many thought it would benefit from better navigation and search function, and greater use of everyday health terms.
• Many patients (71% in our research) are going private not because they want to, but because they feel they have to, especially in the context of much longer waiting-lists and their impact; they also ‘mix and match’ between NHS and private treatments.
• Patients consult multiple sources of information before making their healthcare choices, with 51% citing the significantly persuasive value of a recommendation from a friend, family member or colleague.
• Patients would value a ‘map of private healthcare,’ with key decision points highlighted. 30% of people surveyed overall were not confident about using private healthcare, and 19% of those who’d had prior treatment in the past three years were still not confident about navigating through it. The lack of knowledge creates anxiety and, for some, the sense that people with better access to information or understanding of the process can obtain faster or better outcomes.
• Location is the key factor when choosing a hospital (58%).
• When researching private healthcare, top topics are hospitals (54%) and procedures (52%).
• A significant majority (84%) of patients said they hadn’t considered treatment abroad. In our focus groups, many spoke of their concern if something went wrong in a foreign context without comparable standards and support that patients might find in the UK.

• The number one challenge facing NHS leaders and their staff is how they balance their books while protecting patient safety given many organisations are having to achieve significant efficiency savings. 
• A comprehensive survey of NHS leaders carried out by the NHS Confederation shows that many NHS organisations are having to meet high efficiency targets of 5% and beyond, with some as high as 11%. This is the tightest financial position NHS organisations have faced in years.
• More than six in ten (61%) of NHS leaders say they will need top-up funding from the government within the year to have a chance of hitting their efficiency targets. 
• This would mean some end the year in deficit against their plans, much like many did in 2023/24. The NHS Confederation has consistently said that this type of ‘boom and bust’ planning hinders NHS leaders’ ability to plan services and represents poor value for money. 
• The main ways NHS leaders say they will reduce spending is by cutting spending on agency, locums and/or bank staff, as well as freezing vacancies. There is a dissonance between the government’s plans to expand the NHS workforce over the next decade through the NHS Long Term Workforce Plan and what NHS organisations are having to do in the short term, which will result in posts being cut or frozen. 
• Two thirds say that industrial action will continue to contribute to them not being able to meet their targets. We are now almost 18 months into the industrial dispute, with further strikes set for late June. The government needs to find a solution as this has become ‘business as usual’ for the NHS, with implications for reducing waiting lists and staff morale.  
• As well as industrial action, the major barriers to improving productivity continue to be lack of capacity in social care and a lack of capital investment, as well as the likely impact of having to cut non-clinical staff who would otherwise play a key role in helping to reform services. More than six in ten (61 per cent) of NHS leaders said they cannot meet their current targets without further capital investment, while more than eight in ten say there needs to be a funding increase for social care. 

• In 2023, 287,997 reports were submitted to PA-PSRS, which is a considerable increase from 2022, but very close to the 2021 total.
• Reports of serious and high harm events increased by 20.6% and 25.0%, respectively, representing the largest annual increases historically.
• Of the 287,997 reports, 96.0% were from hospitals, 3.8% were from ambulatory surgical facilities, and 0.2% were from birthing centres and abortion facilities.
• The vast majority (95.9%) of the 2023 reports were incidents, with the remaining 4.1% classified as serious events.
• The reporting rate based on event occurrence date for hospitals in the first half of 2023 was 30.0 reports per 1,000 patient days; for ASFs, the rate was 9.9 reports per 1,000 surgical encounters.
• For each of the past five years, the most frequently reported event type was Error Related to Procedure/Treatment/Test, which accounted for 33.1% of acute care event reports submitted in 2023.
• From a distribution perspective, the greatest increase in percent of total reports in 2023 occurred with event type Medication Error, and the greatest increase for serious events was with event type Complication of Procedure/Treatment/Test (P/T/T).
• Almost half of the increase in Complication of P/T/T was with subtype Complication following surgery or invasive procedure (48.2%; 968 of 2,009), and 54.6% (529 of 968) of reports in this subtype were due to unplanned returns to the operating room.

1. Assessment: A more balanced and comprehensive set of global patient safety indicators is required to address the data gaps identified in this report, and to ensure comparable data is available for all countries. Consensus is required on the minimum set of indicators that all countries should report on.
2. Adoption: A global repository of safety measurement and improvement interventions should be developed and made freely available to frontline teams of practitioners and researchers across the world.
3. Activation: To ensure the faithful adoption of interventions, patients, families and carers must be given the agency to become active and equal partners in the delivery of safe care.