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Keep up to date with the latest news, research and activity in patient safety.

Health visitors call for limits on 'impossible' 1,000-family caseloads

Limits should be introduced on the "unmanageable" caseloads of health visitors in England, with some now responsible for more than 1,000 families each, the Institute of Health Visiting (iHV) has said.
The number of health visitors - qualified nurses or midwives who support families with very young children - has almost halved in the last decade.
In January, the Health and Social Care Committee said the government would fail in its ambition to give every child the best start in life, unless it took urgent action to rebuild the workforce.
The Department of Health and Social Care (DHSC) says the government is "committed to strengthening health visiting services".
Emma Dolan, a health visitor with Humber Teaching NHS Foundation Trust in Hull, says her "top priorities" are to spot potential issues early, and offer advice to parents on things like their baby's wellbeing and sleep to prevent problems arising later.
"We want our babies to live long and happy lives [by] giving that support nice and early and making sure that families know what services are out there."
However, BBC analysis has shown the number of health visitors in England has fallen from 10,200 a decade ago, to 5,575 in January - a drop of 45%.
iHV chief Alison Morton says families are paying the price for the decline in the workforce.
"We need to set a benchmark, otherwise we're just going to continue to see this decline with hugely unmanageable, unsafe caseloads which are impossible for health visitors to work within," she says.
"Health visitors are having to prioritise, and actually prioritisation has a human cost.
"They're having to tell families: 'I'm sorry, I can't do that extra follow-up visit', when you know it would have made a massive difference to that family."
Even if England did bring in safe staffing limits, according to Morton, there aren't enough health visitors currently employed to provide that level of coverage.
"We need more health visitors so that we can have manageable caseloads," she says.
Read full story
Source: BBC News, 20 April 2026
Patient Safety Learning

Pregnancy vaccine reduces baby hospital admissions for RSV by 80%

A vaccine during pregnancy which protects newborns against nasty chest infections is cutting hospital admissions of babies by more than 80%, UK health officials say.
A virus, called RSV, affects many babies in the first few months of life and can leave them gasping for breath and struggling to feed, with more than 20,000 babies ending up seriously ill in hospital in the UK every year.
Since 2024, women have been offered a vaccine from 28 weeks of pregnancy to protect their newborns.
A new study analysing the impact of the vaccine shows it gives "excellent protection" to babies when they are most vulnerable to RSV, the UK Health Security Agency (UKHSA) says.
RSV (respiratory syncytial virus) is one of the main reasons young babies are admitted to hospital before the age of one.
Half of newborns catch the virus, which can cause anything from a mild cold to a life-threatening chest infection because of inflammation in the lungs. Small numbers die from it every year.
The new vaccine was introduced in the UK in 2024 after clinical trials showed it could boost a pregnant woman's immune system enough to pass on protection to the baby through the placenta.
This means babies born to vaccinated pregnant women are protected from the day they are born.
This new study shows the protection is nearly 85% when given at least four weeks before baby is born. Some protection is still possible if the jab is given later than this.
Read full story
Source: BBC News, 18 April 2026
Patient Safety Learning

NHSE sets requirements for neighbourhood health centres

A building can be designated a “neighbourhood health centre” (NHC) without offering mental health services, urgent or minor-injuries care, diagnostics or an on-site pharmacy, as determined by NHS England criteria published this week.
Guidance issued by NHSE set the minimum threshold for a building to qualify as an NHC at two functions: an on-site general practice and a community health or integrated neighbourhood team presence. Centres must be open at least 12 hours a day, six days a week.
All other services commonly associated with a “one-stop shop” health centre appear only in the larger tiers of the accompanying design specification, or are not required at any tier.
The specification sets out three tiers of NHCs. It notes, however, that: “The precise mix of complementary services, including diagnostics and other hospital-to-community functions, will vary by place according to local need and the wider service model.”
In relation to NHC’s mental health services, the guidance says it “focuses on primary care‑led and early intervention support, closely integrated with GP services”, meaning “community-based mental health centres complement, rather than replace, NHCs”.
Read full story (paywalled)
Source: HSJ, 15 April 2026
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FDA asks drugmaker Eli Lilly for more safety information on its new GLP-1 weight loss pill

A GLP-1 weight loss pill, already on sale in the United States, has hit a regulatory snag.
The Food and Drug Administration has asked U.S. drugmaker Eli Lilly to collect more long-term safety data on its once-daily tablet Foundayo, according to an 1 April letter published by the FDA Tuesday.
The FDA approved the pill under its programme to fast-track drugs using 72-week, Phase 3 trial data but still needs to look at years-long data to understand all of the potential risks.
At the heart of the request is whether taking Foundayo - made using a new active ingredient called orforglipron - could be linked to liver, heart and gastrointestinal problems.
“We have determined that only a clinical trial (rather than a nonclinical or observational study) will be sufficient to assess a signal of a serious risk of retained gastric contents and to identify an unexpected serious risk for major adverse cardiovascular events, drug-induced liver injury and exposure to [Foundayo] during lactation,” the FDA wrote.
Eli Lilly has until the end of April to complete that clinical trial and until July to submit a final report.
An Eli Lilly spokesperson told The Independent that “patient safety is Lilly’s top priority” and that the company actively monitors, evaluates and reports safety information for all its medicines.
Read full story
Source: The Independent, 16 April 2026
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Fourteen trusts rated red for ‘capability’

NHS England has rated 14 trusts “red” for “capability” – meaning their management has been unable to “grip” long-running problems.
This week, NHS England published the first “provider capability” ratings, part of its overhauled oversight framework.
According to the framework, a “red” rating means there are “material or long-running concerns” that management “has been unable to grip”.
The 14 providers with this rating are all acute trusts, and include three large hospital groups: Leeds Teaching Hospitals Trust and University Hospitals Sussex Foundation Trust – both of which have seen  serious concerns raised about maternity failings – and Mid and South Essex FT.
The majority (nine) of the “red” trusts are in the north of England, while there are two each from the South East and East of England, and one in the South West. Nine of them serve coastal areas.
The ratings are based on self-assessments, which were then subject to review by NHSE regional teams. The process was carried out from August to December last year. There have already been a number of leadership changes at “red”– rated trusts since the exercise began.
Read full story (paywalled)
Source: HSJ, 17 April 2026
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USA: Florida surgeon indicted after removing liver instead of spleen

A surgeon in Florida has been indicted for manslaughter after he wrongly removed a patient’s liver instead of his spleen during an August 2024 procedure.
Thomas Shaknovsky, 44, was indicted by a grand jury in Tallahassee on Monday after prosecutors said he botched the surgery of 70-year-old William Bryan, of Muscle Shoals, Alabama.
The jury of the first judicial circuit heard that Shaknovsky, of DeFuniak Springs, 120 miles (193km) west of Tallahassee, had been scheduled to perform an operation called a laparoscopic splenectomy on the patient, but instead cut out the man’s liver.
The consequence was “catastrophic blood loss and the patient’s death on the operating table”, according to a press release from Michael Adkinson, the Walton county sheriff.
Thomas Shaknovsky was indicted on Monday in Tallahassee after prosecutors said he botched the surgery of 70-year-old William Bryan. Photograph: Walton county sheriff’s office
Shaknovsky was taken into custody in Miramar Beach, Florida, on Monday morning and taken to the Walton county jail ahead of a scheduled first court appearance on Tuesday, the sheriff said.
Court filings, and an emergency order of license suspension by the Florida department of health less than a month after Bryan’s death, detailed how Shaknovsky allegedly insisted that he press on with the operation at Ascension Sacred Heart Emerald Coast in Miramar Beach even after it was obvious he had made a mistake.
“Dr Shaknovsky removed an organ he believed to be the spleen, but due to his shock and the chaos, he was unable to properly identify the organ,” prosecutors said.
Read full story
Source: The Guardian, 14 April 2026
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Coroner calls for changes to how asthma attacks are assessed after ‘skin tone’ confusion in death of 22-year-old

A coroner has called for urgent improvements to how asthma attacks are assessed by emergency services after a mixed-race 22-year-old died due to a misinterpretation of him being described as a 'deathly colour'.
Roman Barr was assessed as not being an urgent case when his parents called for an ambulance, and was told he would have to wait several hours for one to arrive.
Mr Barr was of mixed race and had a 'darker skin tone', so the description of being a 'deathly colour' was misinterpreted, even though he had 'bluish lips' and was critically ill.
A lack of ambulance availability meant that he died on the way to the hospital when his parents decided to drive him themselves after suffering a cardiac arrest.
Now a coroner has said that early intervention from emergency services could have prevented Mr Barr's death.
On December 14 2023, Mr Barr was at work when he had an asthma attack, and his dad took him home, where he tried to use his inhaler but had no improvement.
His dad called for an ambulance, but he was not assessed as a 'critical' case, and his family was told it would take several hours for an ambulance to be available.
His family called 999 three times, but when his dad assessed his symptoms to the call handler, he misunderstood what they meant by a 'deathly colour'.
He told the call handler that his son was of mixed race and had a 'darker skin tone', so he was seen as not being in a critical condition.
Mr Barr had 'bluish lips' at the time and was 'critically unwell'.
At Mr Barr's inquest, it was found that he died from asthma and a narrative conclusion was given.
This conclusion said: "The deceased died as a result of an asthma attack.
"Information indicating the need for an urgent ambulance response was not obtained, and because no ambulance was available for several hours, he was taken to hospital by his family.
"On the balance of probabilities, earlier intervention by an emergency ambulance would have prevented his death.”
Read full story
Source: The Independent, 16 April 2026
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NHS could face drug shortages within weeks, medicine manufacturers warn

The NHS faces drug shortages within weeks if the US and Iran do not strike a deal to end the conflict in the Middle East, drug makers have warned.
Paracetamol, antibiotics, stroke prevention medicines and even some cancer drugs, which represent 85% of all NHS prescriptions, may be in short supply as early as June, according to Medicines UK.
The company told The Telegraph it was “increasingly concerned that some chemicals and solvents used to manufacture active pharmaceutical ingredients are now in very short supply”.
Medicines that contain paracetamol and aspirin are thought to be the most at risk because they are manufactured using by-products from the petrochemical industry, which has been affected by Tehran’s blockade of the Strait of Hormuz.
The shortages may make it harder to fulfil patients’ prescriptions or make it more expensive for health services to source the medicines, the regulator warned.
Richard Sullivan, professor of cancer and global health at King’s College London, warned there was a shortage of cancer drugs. He told The British Medical Journal that “disruption in supply chains for cancer drugs and consumables for robotic surgery, which uses up an awful lot of equipment every time you operate on somebody”.
Dr Leyla Hannbeck, CEO of the Independent Pharmacies Association, explained that a significant proportion of pharmaceuticals rely on petroleum-derived inputs, which are used in many common medicines, from antibiotics to pain relief and chronic disease treatments.
Read full story
Source: The Independent, 16 April 2026
Related reading on the hub:
Creon shortages: “It’s just another thing patients with cystic fibrosis could do without” Medicines shortages: minimising the impact on patients (a blog by Catherine Picton)  
Patient Safety Learning

NHS ‘a cat’s whisker’ from hitting headline targets

The NHS was within touching distance of its headline urgent and emergency care targets in March – falling just short of the key asks in A&E and ambulance wait times.
Four-hour accident and emergency response times hit 77.1% in March, against a national recovery target of 78% for the end of the financial year.
Meanwhile, the category two ambulance response time target of 30 minutes across 2025-26 was missed by just four seconds after a couple of months of sustained improvement.
NHS England said A&Es faced a record 2.43 million attendances in March, pointing to last month’s meningitis outbreak. Meanwhile, the category two ambulance response time of 26:18 in March alone was the best performance since May 2021.
HSJ analysis reveals around 34 acute trusts deteriorated against the four-hour A&E target in 2025-26 compared to the previous year; however, the vast majority improved.
Read full story (paywalled)
Source: HSJ, 16 April 2026
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Rollout of Covid vaccines extraordinary feat - inquiry report

The rollout of Covid vaccines – the largest immunisation programme in UK history - was an "extraordinary feat", the Covid inquiry said.
The fourth report from the inquiry praised the speed in which jabs were developed and deployed – 132 million were given in 2021 - alongside how the UK discovered which treatments worked best against the virus.
The positive headlines contrast with the first three reports that were highly critical of the government's pandemic planning, decision-making and management of the NHS.
But the report said more needed to be done to address vaccine hesitancy and those harmed by the Covid jabs should have easier access to bigger payouts.
Inquiry chair Baroness Hallett praised the vaccine programme, pointing to research which suggested it saved more than 475,000 lives after more than 90% of people aged over 12 came forward for a jab.
But she said while most people took up the offer of vaccination, there was lower uptake within communities in areas of higher deprivation and in some ethnic minority communities.
"Governments and health services must work with communities to rebuild trust and promote a better understanding of, and confidence in, vaccines," she said.
Spread of false information online and lack of trust in authority, combined with how quickly the vaccines had been developed, were contributory factors, said the report.
Read full story
Source: BBC News, 16 April 2026
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Anxiety drug Xanax under recall in the USA

Xanax, a drug used to treat anxiety disorders, has been placed under a nationwide recall in the USA
Viatris, the maker of Xanax, recalled the medication last month because of “failed dissolution specifications,” according to a recent notice from the Food and Drug Administration.
This means the pill may not break down in the body and release the drug at the right speed. If the medication doesn’t dissolve correctly, it could reduce its effectiveness.
Last week, the FDA classified the recall as Class II, meaning the affected pills could cause “temporary or medically reversible adverse health consequences or where the probability of serious adverse health consequences is remote,” according to the agency.
A Viatris spokesperson told The Independent, “Patient safety and the quality of our medicines are of the utmost importance to Viatris. The voluntary recall of Xanax XR in the U.S. is specific to one lot of one strength (3mg) of the brand product only, and no other batches of the Xanax XR brand product, or its generics, are impacted.”
Viatris said patients don’t need to take any action in connection with the recall and that wholesalers and pharmacies have been provided with instructions on how to return the affected Xanax. The drug maker said they have not received any reports of adverse reactions from the recalled product as of Wednesday.
Read full story
Source: The Independent, 16 April 2026
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Alzheimer’s drugs ‘make no meaningful difference to patients’, major review suggests

Drugs aimed at slowing Alzheimer's disease progression "make no meaningful difference to patients" while raising the risk of brain swelling and bleeding, a new review has claimed.
However, charities have swiftly challenged these findings, accusing experts of unfairly combining failed and successful drug trials.
Researchers behind the review stated that the effects of these medicines on individuals with early-stage Alzheimer's and dementia were "either absent or consistently small".
Edo Richard, a professor of neurology at Radboud University Medical Centre in the Netherlands, noted his team observed "results from trials over the last two decades 'are not consistent'".
Charities argue that the review's authors have attempted to "paint an entire class of drugs with the same brush", potentially undermining the benefits of certain treatments. Anti-amyloid medicines work by binding to and clearing protein deposits in the brains of those with Alzheimer's, a process intended to slow cognitive decline.
The treatments were not approved for use on the NHS after the National Institute for Health and Care Excellence (Nice) deemed their benefits “too small” to justify the cost.
The new Cochrane review looked at 17 studies involving 20,342 patients overall.
The analysis found that the effects of these drugs on cognitive function and dementia severity after 18 months was “trivial”.
According to Prof Richard, the differences made by the treatments were “far below the minimal effect that’s needed to be noticeable at all for patients and caregivers”.
Dr Susan Kohlhaas, executive director of research at Alzheimer’s Research UK, said the charity regularly heard from families impacted by dementia who said that even a delay of several months in their loved one’s decline “could provide valuable, meaningful time” that “shouldn’t be minimised”.
She said: “Crucially, this study is attempting to paint an entire class of drugs with the same brush even though we know different anti-amyloid treatments can act in different ways.
“Anti-amyloid treatments will not be the whole answer to curing Alzheimer’s, and research is already moving towards a wider range of biological targets.
“But it’s not accurate to dismiss their impact as ‘trivial’, especially when the analysis has clear constraints that limit what it can tell us.”
Read full story
Source: The Independent, 16 April 2026
Patient Safety Learning

Nearly half of Americans hold some form of vaccine skepticism, poll finds

Nearly half of Americans are somewhat skeptical of vaccines, a new poll has found.
Some 46% of U.S. adults who responded to a Public First poll by Politico in March agreed that “facts on vaccines are still up for debate and it is damaging to enforce their uptake.”
In contrast, only 39% said that the science on vaccines “is clear and it is damaging to question it.”
The results of the survey are in line with the views of Health Secretary Robert F. Kennedy Jr., a longtime vaccine skeptic and founder of the Republican “Make America Healthy Again” movement.
“What stands out is that vaccine safety and vaccine choice are no longer fringe issues,” Mary Holland, CEO of anti-vax group Children’s Health Defense, which Kennedy previously led before taking his post in government, told Politico.
“People want to be able to make their own medical decisions.”
Astonishingly, overall, 39% of respondents to Politico’s survey said they would allow vaccine-preventable diseases to return, rather than force people to have vaccines, in contrast to 47% who said they would rather not.
During his tenure as Health Secretary, Kennedy has overseen several major changes within his department and its policies, including the attempted overhaul of the Centers for Disease Control and Prevention and the elimination of Covid-19 vaccine recommendations.
Last week, it was reported that the CDC had delayed publishing a report showing the benefits of the Covid vaccine, further sparking concerns that the information conflicted with Kennedy’s views. The CDC insisted that the move followed standard procedure.
Read full story
Source: The Independent, 14 April 2026
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Study finds that hospital care at home could save the NHS hundreds of millions

Treating patients with serious conditions from the comfort of their own homes could deliver far greater benefits than previously thought, saving the NHS hundreds of millions of pounds while improving care quality and patient satisfaction, according to a major new study.
The most comprehensive evaluation of the ‘Hospital at Home’ model to date has found that patients cared for through West Hertfordshire Teaching Hospitals NHS Trust’s Virtual Hospital, delivered in partnership with Central London Community Healthcare NHS Trust, overwhelmingly preferred home‑based care to traditional hospital treatment.
The peer‑reviewed study, published on 8 April in Frontiers in Digital Health, analysed outcomes for 3,000 patients admitted to the Hospital at Home service between April 2023 and April 2024.
The findings demonstrate not only strong clinical and patient experience benefits, but also a compelling economic case for scaling up Virtual Hospital models across the NHS.
The evaluation found that Hospital at Home care significantly reduced the time patients spent receiving acute treatment.
Key findings include:
Early Supported Discharge patients spent 2.8 fewer days in care on average compared with similar hospital patients. Hospital at Home care costs £118.49 per bed day, compared with £569 for inpatient hospital care. Savings of £486 per Early Supported Discharge patient. Savings of £3,652 per Admission Avoidance patient. Overall, the programme delivered net savings of £1.33 million over 12 months.
Patient experience was a major strength of the Virtual Hospital model.
The study found that 95.8% of patients preferred Virtual Hospital care, and 98.3% of patients said they felt safe while being treated at home.
Read full story
Source: National Health Executive, 14 April 2026
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Police expand NHS death inquiry to heart patients

A major investigation into the care of more than 200 NHS cases has been expanded to include a "small number" of heart patients, confirms Sussex Police.
The force is looking into allegations of medical negligence at the Royal Sussex County Hospital in Brighton between 2015 and 2021 as part of Operation Bramber.
Officers are examining claims about preventable deaths and injuries in the trust's neurosurgery and general surgery departments.
University Hospital Sussex NHS Trust, which runs seven hospitals across East and West Sussex, said it would continue to "fully co-operate" with the police investigation.
Initially, 40 deaths were investigated as part of Operation Bramber, which was launched by the police in 2023, after both a coroner and two consultant surgeons at the hospital raised concerns.
A spokesperson for Sussex Police said: "As a result of a further witness coming forward during the course of the investigation, police are now starting to review a small number of cases relating to cardiothoracic surgery at the Royal Sussex County Hospital."
And added: "Cases relating to neurosurgery and general surgery at the Royal Sussex County Hospital in Brighton between 2015 and 2021 have started to be reviewed by specialist consultant surgeons who are totally independent of University Hospitals Sussex NHS Foundation Trust.
"They have been commissioned to provide expert medical opinion on individual cases, and their reports will be considered alongside information obtained from our police enquiries to determine whether any cases will be taken forward and if so, which ones."
Read full story
Source: BBC News, 15 April 2026
Patient Safety Learning

Patients forced to chase NHS test results in admin ‘doom loop’

Two-thirds of patients (66%) have experienced at least one NHS admin problem in the past year, according to a new study.
The report from the King’s Fund, Healthwatch and National Voices exposed the admin “doom loop” with patients being forced to chase NHS test results, receiving appointment reminders after the date has passed, not being kept informed about waiting times and being given incorrect information.
The report, based on responses from 1,908 adults in December, said: “The results overall make for difficult reading. Not only has there been little change in people’s experience of NHS admin since our previous polling (2024), but general perceptions of NHS admin and communications have actually gotten worse.
“Less than half of those polled think the NHS is good at communicating with patients about things like appointments and test results, and around a third think it is poor at various aspects of communication with patients.
“When we asked people how good or poor the NHS is at communicating with patients about things like appointments and test results, over two in five (43%) said it was good, while nearly one in three (30%) said it was poor.
“This is worse than in 2024, when over one in two (52 per cent) said it was good and one in four (25 per cent) said it was poor.”
The study found responses to particular aspects of admin have got worse.
For example, in 2025, 32% of people said the NHS is good at ensuring patients have someone to contact about ongoing care (down from 43% in 2024), while just over 34% said it is poor (compared with 28% in 2024).
People with long-term health conditions were more likely to say the NHS is poor, while carers and those on lower incomes were also more likely to say the same.
Read full story
Source: The Independent, 16 April 2026
Related reading on the hub:
The challenges of navigating the healthcare system  
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