Mark Hughes

The Invisible Hazard: Tackling Surgical Smoke for Healthcare Worker and Patient Safety will delve into the risks posed by surgical smoke, its impact on both healthcare professionals and patients, and the latest safety measures to mitigate these dangers. This webinar, hosted by the Safety For All campaign, will provide valuable insights into the health risks associated with inhaling surgical smoke, the current legislation governing its management, and the introduction of smoke evacuation products to enhance safety in operating theatres. This session is essential for perioperative practitioners, safety officers, healthcare professionals, and policymakers looking to better understand the hidden risks of surgical smoke and explore practical solutions for improved workplace safety. Speakers 🔹 Lisa Nealen – A Perioperative Practitioner at Gateshead Health NHS Foundation Trust, Lisa brings hands-on experience in the surgical field and will share insights into the real-world challenges of managing surgical smoke in operating theatres. 🔹 Daniel Rodger – A Senior Lecturer in Perioperative Practice at London South Bank University and a registered Operating Department Practitioner (ODP), Daniel is a specialist in perioperative safety and will outline evidence-based practices for surgical smoke safety. Key Topics The health risks of surgical smoke exposure for healthcare workers and patients Current legislation and standards regarding smoke evacuation in healthcare settings The introduction and benefits of smoke evacuation products in perioperative environments Best practices for mitigating risks and implementing safety protocols in operating theatres Live Q&A Session The webinar will conclude with an interactive Q&A session, where attendees can engage directly with our expert speakers, ask questions, and explore strategies for improving surgical smoke safety in their workplaces. Don’t miss this opportunity to hear from leading experts, gain actionable knowledge, and contribute to a safer and healthier surgical environment. Register here.

A year ago today the Patient Safety Commissioner for England published The Hughes Report, which set out options for redress for those who have been harmed by valproate and pelvic mesh. In this blog, Patient Safety Learning reflects on the failure to act on its recommendations 12 months on. The Independent Medicines and Medical Devices Safety (IMMDS) Review published its report, First Do No Harm, on 8 July 2020. It examined how the healthcare system in England responds to reports about harmful side effects from medicines and medical devices, focusing on three medical interventions: hormone pregnancy tests (HPTs) sodium valproate pelvic mesh. The report outlined how these interventions had resulted in a truly shocking degree of avoidable harm to patients over a period of decades. It made nine recommendations as part of this, two of which specifically concerned redress options for patients: “Recommendation 3: A new independent Redress Agency for those harmed by medicines and medical devices should be created based on models operating effectively in other countries. The Redress Agency will administer decisions using a non-adversarial process with determinations based on avoidable harm looking at systemic failings, rather than blaming individuals. Recommendation 4: Separate schemes should be set up for each intervention—HPTs, valproate and pelvic mesh—to meet the cost of providing additional care and support to those who have experienced avoidable harm and are eligible to claim.”[1] Though the Government initially rejected both these recommendations, patients and family members harmed by these medical interventions continued to tirelessly campaign for appropriate redress.[2] Responding to this, in early 2023 the then Minister for Mental Health and the Women’s Health Strategy, Maria Caulfield MP, signalled that the Government would be willing to look again at the issue of redress. She commissioned the Patient Safety Commissioner for England to explore redress options for those who have been harmed by two of the interventions covered by the IMMDS Review: sodium valproate and pelvic mesh. The Hughes Report Published on the 7 February 2024, the Patient Safety Commissioner set out options for redress for those harmed by pelvic mesh and sodium valproate in The Hughes Report.[3] At the core of its recommendations is a proposal to create a two-stage financial redress scheme. Responding at the time, we set out our support for these recommendations.[4] Patient Safety Learning believes, like many individual patients and patient groups, that there must be redress options for patients harmed by the interventions covered by the IMMDS Review. There is considerable evidence that for many patients the clinical negligence route is simply not viable and, in the absence of any system of redress, this leaves them with no assistance to help meet the cost of any additional care and support they may need. We also believe that this should extend to those affected by hormone pregnancy tests, who fell outside of the scope of The Hughes Report’s recommendations. Excluding patients and family members affected by hormone pregnancy tests from redress is not acceptable or in keeping with the spirit of the IMMDS Review’s recommendations. Commenting on this, our Chief Executive Helen Hughes said: “It is now over four and a half years on from the redress schemes first being recommended by the IMMDS Review. We think that it is unacceptable that there has been no response to The Hughes Report, over a year after its publication. Patients and their families are suffering unacceptably without redress schemes. The Government must respond to this report promptly and take steps to deliver redress for all those affected by pelvic mesh, sodium valproate and hormone pregnancy tests as a matter of urgency.” References The IMMDS Review. First Do No Harm, 8 July 2020. Department of Health and Social Care. Government response to the report of the Independent Medicines and Medical Devices Safety Review, 21 July 2021. Patient Safety Commissioner for England. The Hughes Report: options for redress for those harmed by valproate and pelvic mesh, 7 February 2024. Patient Safety Learning. Reflections on The Hughes Report: Pelvic mesh, sodium valproate, hormone pregnancy tests and options for redress, 20 February 2024.

This document provides a framework for improving health care outcomes, patient safety and public trust in Greece. The Strategy includes 11 objectives and 47 prioritised actions, which are designed for phased, stepwise implementation. These actions focus on improving patient safety, governance, clinical guidelines and health literacy across all levels of the health care system. The vision of the Strategy is to build a health care system where quality is a daily commitment, ensuring that all individuals trust that health care will be safe, respectful, equitable and efficient. The Strategy aims to achieve the following key objectives: To nurture an efficient, accountable and data-driven health system: strong leadership and governance are essential for ensuring operational efficiency and evidence-based decision-making. Effective governance structures set clear policies, enforce accountability and ensure transparent oversight. By systematically collecting and analysing data, the country can continuously improve health care performance and decision-making. This approach fosters a culture of accountability and enables timely, informed responses to health care challenges. To foster trust in an effective and safe health system: building public trust requires a focus on patient safety, clinical outcomes and the reliability of health care services. Evidence-based practices, integrated with innovative solutions, are key to enhancing safety, accessibility and overall patient outcomes. This will help to ensure that the health care system operates reliably, fairly, and efficiently, increasing trust among patients, health care workers and the wider public. To create patient partnerships in health care provision: empowering patients to take an active role in managing their own health care is essential for developing a high-performing and cost-effective health care system. This approach leads to better resource allocation, enhanced satisfaction for both patients and providers, greater utilization of preventive services and improved health outcomes. Patients must understand their health conditions, treatment options and care processes if they are to make informed decisions. Health literacy, especially digital health literacy, equips individuals to engage effectively with health care providers. The Strategy aims to ensure that patients, families and providers collaborate to personalize care, respecting individual values and preferences and thereby improving the overall quality of care. The Strategy is structured using three strategic directions. Leadership and governance: this direction focuses on building a strong foundation for the health system through effective leadership, transparent governance and the integration of evidence-based practices. When the system operates efficiently and responsibly, it can better address the needs of the population. Evidence and innovation: this direction emphasizes the importance of continuous innovation and the integration of evidence-based practices and focuses on improving safety, effectiveness and equity in health care. By embracing new technologies and approaches, the country can enhance the reliability of its health system. Literacy and engagement: this direction emphasizes patient empowerment through improved health literacy and engagement of patients in care decisions. Ensuring that patients are well informed and fully involved in their care leads to better outcomes and strengthens the patient–provider relationship.

On the 16 January 2025, the Royal College of Nursing (RCN) published a new report presenting the findings of a survey of nursing staff outlining the extent of corridor care across the UK. This blog sets out Patient Safety Learning’s response to this report. In a new report this month, On the frontline of the UK’s corridor care crisis, the RCN have set out in stark terms how corridor care has become normalised in the NHS.[1] [2] Documenting the experiences of more than 5,000 nursing staff, the report reveals the widespread issues of corridor care across the UK. It also highlights from a survey of RCN members that: Almost 7 in 10 (66.8%) of those surveyed said they were delivering care in over-crowded or unsuitable places. More than 9 in 10 (90.8%) of those surveyed said patient safety is being compromised. Corridor care can broadly be defined as care being provided to patients in corridors, non-clinical areas or unsuitable clinical areas because of a lack of hospital bed capacity. In the RCN survey, when asked what inappropriate settings staff had provided care for patients, the main responses were corridors (62.34%), additional bed or chair in a bay (16.12%) and waiting rooms (5.93%). However, 15.31% of respondents also cited other settings, including bathrooms, cloakrooms, chairs in lounges, store cupboards and ward reception areas. Implications for patient safety Corridor care raises significant patient safety concerns. It can present problems providing appropriate care, as these unsuitable spaces can make it difficult to administer specific treatments, such as intravenous medication, or the ability to access oxygen, medication and lifesaving treatment in an emergency. It also makes it more difficult to monitor patients, which can result in delays in providing further treatment if their condition begins to deteriorate. But it is not just the physical environment that’s the challenge, it’s also an indication of an organisation that isn’t coping with the demand and capacity being exceeded, in the emergency department and also on the wards. The overspill into corridors is a reflection of that. It is also highly likely that the organisational infrastructure and clinical support services are struggling to cope—for example, getting diagnostic tests and scans. These will take longer, contributing to delays in clinical review and decision making, which in turn could lead to delays in treatment and care. The constraints on space that working in these conditions impose may mean that relatives are not able to be accommodated, reducing their ability to support patients whose condition may not otherwise be closely monitored. This lack of space can also result in physical hazards, with the potential for escape routes becoming blocked in emergencies. Corridor care also has a particular negative impact on patient dignity and confidentiality. Reflecting of examples of this in practice, in a blog shared on the hub last year a nurse noted that: “Often, we need to perform an ECG, which involves removing clothes from the upper body. There is supposed to be a room set aside for this, but it is often occupied by someone else in need—a mental health patient, a family member or a woman who has just miscarried. This task then has to be completed in the corridor. The screens we have do not provide any privacy and this leaves patients feeling exposed, vulnerable and cold. One other example relating to this lack of dignity happened when a patient’s catheter overflowed because it had not been emptied. He was on a narrow trolley with a thin mattress and had become very wet. I simply couldn’t offer him the personal care he needed. There was not enough space, no privacy and no easily accessible hot water. Once I was able to gain support from staff to help me change the patient he had been laying in wet clothes and sheets for the whole morning—four hours. This is basic nursing care that I was not able to perform."[3] Working in these conditions also has a significant impact on healthcare professionals too, trying to do their best in less than ideal circumstances that are now a daily occurrence. No-one joins a caring profession to continually deliver sub-optimal care that isn’t safe and this adds to the trauma already experienced by patients. Reflecting this, the RCN report included the following response highlighting the impact on one staff member: “It was cold room with no natural light or access to toilet or shower facilities near by. Temporary measure for no beds in the hospital. Patients felt undervalued and forgotten about. It was out the way of the main ward and felt unsafe. I escalated these concerns nothing was done. I am now in the process of leaving the NHS due to the pressure and culture after a 10 year nursing career. It is fraying at the seam’s and has left me with mental health problems and trauma.”[1] Normalisation of corridor care Thirty years ago corridor care was rare, but it is now so normalised that in September last year NHS England published new guidance setting out principles for providing safe and good quality care in what it describes as ‘temporary escalation spaces’ (TES).[4] The guidance contradicts itself stating that the delivery of care in temporary escalation spaces is not acceptable, but then goes on to say that the principles have been developed to support staff to provide the safest, most effective and highest quality care possible. Reflecting on this from a frontline NHS perspective, a anonymous blog contributor on the hub highlighted various problems with this position, stating that: “I am unsure which patients are ‘suitable’ for the corridor. I am not aware of anyone who would like to be cared for in an open space, with no privacy or dignity, with no access to emergency equipment or appropriate staffing.”[5] This guidance has also drawn national criticism in the form of a position statement issued from the Royal College of Emergency Medicine in December 2024, stating that: “Advice from arm’s length bodies that appear out of touch with what is happening in our departments was always going to be poorly received. Where such spaces are in use it is inevitable that this will be associated with long waits in Emergency Departments. We know that long waits in Emergency Departments are associated with measurable harm to patients. Care will therefore not be safe.”[6] Further to this guidance, we are also now seeing corridor care become part of workforce planning, with examples of Trusts specifically recruiting nursing roles specifically to carry out shifts in corridors.[7] A systemic problem Corridor care is a complex issue that is the result of a range of systemic problems faced by the health and care sector. The roots of this have been considered in a range of previous articles and reports, and recently in a report by the RCN published last summer, Corridor care: unsafe, undignified, unacceptable.[8] [9] [10] Factors contributing to there being insufficient capacity in hospitals that are leading to the persistence and growth of corridor care include: Lack of sustainable investment across the health and care system. Infrastructure investment, in both new healthcare facilities and essential maintenance for existing buildings, not keeping pace with service requirements. Increasing healthcare demand, with an ageing population living for longer in ill health. ·Lack of hospital bed capacity, exacerbated by delayed hospital discharges due to a lack of access to appropriate social care. Staff shortages, with demand for health and care services outstripping workforce growth. Patients waiting longer for diagnostic tests or elective services and becoming more unwell whilst they wait, which could lead to an increase in demand for emergency care. Lack of investment in prevention and public health, with worsening wider population health. Commenting on the winter pressures faced by the NHS, the Health and Social Care Secretary Wes Streeting MP said in the House of Commons this week: “I want to be clear, I will never accept or tolerate patients being treated in corridors. It is unsafe, undignified, and I am determined to consign it to the history books.”[11] There is no quick fix to achieve this. It will require system leaders to get to grips with these issues and, supported by evidence and research, put in place plans to address them. If the Government is to realise its ambition to consign corridor care to the history books, this work must be an integral part of the forthcoming 10-Year Health Plan.[12] Reporting incidences of corridor care Patient Safety Learning believes that corridor care should be avoided whenever possible. Even in the context of the ongoing immense pressures being faced by the health service, this should not be normalised. In situations where this is unavoidable, there clearly needs to be guidance and safeguards put in place to minimise risks as far as possible. But we do not think this can ever really be characterised as good quality care, which is far removed from the patient and healthcare professional experience of this. As we have noted, to eliminate corridor care will ultimately depend on long-term action to address its systemic causes. However, we do think there are actions that can be taken now to better understand and respond to the patient safety problems that this raises. We support the recent calls by an RCN-led coalition on the UK government to commit to transparency on the true extent of the corridor care. It is important that there is regular reporting of incidents of corridor care, and we agree with their recommendation that: “Mandatory reporting about incidents of care in inappropriate spaces, including TES, must be implemented by the UK government to NHS England, in partnership with local NHS Trusts. This data should be released publicly on a regular basis alongside A&E attendance and waiting time data, forming part of NHS England’s winter situation report data series and monthly performance statistics release.”[13] We also welcome the recent NHS England announcement that it will begin to report on the number of patients who receive care within temporary escalation spaces from the 25 January onwards.[8] Capturing the patient safety consequences of corridor care While it is important incidences of corridor care are regularly recorded, we also need to better understand the patient safety consequences of this and how organisations are mitigating risks to patients and staff. We believe that the NHS needs to give further consideration as to how incidents of avoidable harm, where corridor care is a contributory factor, are captured. One aspect of this would be looking at how such incidents can be recorded in the Learn from Patient Safety Events (LfPSE) service. LfPSE is the national NHS service for the recording and analysis of patient safety events that occur in healthcare. Trusts can currently see reports of their own data in this, but it would be beneficial if they could also access system-wide findings from this on issues such as corridor care to help them assess risk or engage with others. Consideration also needs to be given to the ease at which staff are be able to record incidents of near misses and incidents in corridor care. If this is an increasingly frequent occurrence, this may become difficult to manage in addition to providing patient care in an overstretched healthcare setting. We also believe that NHS England should look at how learning and recommendations from investigations related to corridor care at individual healthcare providers under the Patient Safety Incident Response Framework are shared widely for national improvement. If patients’ safety has been compromised by being cared for in unsuitable environments, this must be captured and shared for learning. We believe that organisations should share how they are mitigating the risks to patient and staff safety. NHS England’s guidance suggests that patient safety considerations should be imperative when using temporary escalation spaces. It states that: “Local patient safety checklists should be used to ensure the patient is safe to be cared for in this setting. This should include an inclusion and exclusion checklist.”[4] However, it is not immediately clear what checklists this is referring to, with a localised approach meaning this could vary from organisation to organisation. There does not currently appear to be much evidence on how organisations are responding to this guidance, or shared examples of where this has been implemented well that could be used by others. Further to this, to ensure we are capturing and acting on the patient safety consequences of corridor care, it is important that: Patients, families and carers are invited to and feel able to feedback about their experiences, both at a local and national level, to inform learning and improvement. Frontline staff are supported and feel able to report patient safety concerns around corridor care. This requires a wider organisational culture that enables speaking up and demonstrates that the organisation listens to and acts on the findings of incident reports. Healthcare managers need to maintain a focus on ensuring patient safety issues relating to corridor care are consistently identified and acted on, despite the enormous pressures the system faces. Organisational leaders should maintain a credible and meaningful focus on patient safety as a priority agenda item internally and externally to create the culture and landscape for solutions to be identified and implemented. However, the above points can only be realised if system leaders, from Integrated Care Boards up to the Department of Health and Social Care, buy into this. This requires honesty and transparency about the scale of corridor care and a commitment to work collaboratively to share practices to minimise the patient safety risks it creates. Share your views and experiences with us We would welcome your views on the patient safety concerns raised in this blog. Are you a patient, or a friend or family member of a patient, who has experienced corridor care? Or perhaps a healthcare professional who has experience of delivering corridor care and would like to share your story? You can share your views and experiences with us directly by emailing [email protected]. References Royal College of Nursing. On the frontline of the UK’s corridor care crisis, 16 January 2025. Royal College of Nursing. Corridor care: ‘Devastating testimony’ shows patients are coming to harm, 16 January 2025. Anonymous. A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift, Patient Safety Learning, 22 February 2024. NHS England. Principles for providing safe and good quality care in temporary escalation spaces, 16 September 2024. Anonymous. A nurse’s response to the NHSE guidance on their principles for providing safe and good quality care in temporary escalation spaces, Patient Safety Learning, 20 September 2024. Royal College of Emergency Medicine. RCEM Position Statement on NHS guidance ‘Principles for providing safe and good quality care in temporary escalation spaces’, 16 December 2024. Lintern S, Wheeler C. Hospital advertises for ‘corridor care’ nurses to ease NHS crisis. The Times, 11 January 2025. Hadden C, Tse J. Corridor care: unsafe, undignified, unacceptable. Royal College of Nursing, 3 June 2024. Wilson H. We shouldn’t get comfortable with corridor ‘care’. The Health Foundation, 14 February 2024. Royal College of Emergency Medicine. The management of emergency department crowding, January 2024. Department of Health and Social Care. Oral statement to Parliament – Health and Social Care Secretary’s statement: winter 2025, 15 January 2025. Department of Health and Social Care. Change NHS: help build a health service fit for the future, 18 November 2024. Royal College of Nursing. Corridor care: RCN-led coalition demands transparency and mandatory reporting, 13 January 2024

Corridor care can broadly be defined as care being provided to patients in corridors, non-clinical areas or unsuitable clinical areas because of a lack of hospital bed capacity. This report from the Royal College of Nursing presents the findings of a survey of nursing staff outlining the extent of corridor care across the UK. The responses confirm that corridor care is a widespread issue, with hundreds of unedited responses included in the report. You can read Patient Safety Learning's response to this report here.

This is the recording of a webinar hosted by the Safety for All Campaign discussing the latest advancements in personal protective equipment (PPE) standards within surgical settings. The session featured presentations by Dr Ali Mehdi and Edward Curtin, who provided in-depth analyses of current PPE protocols and their implications for perioperative safety. Their insights sparked a dynamic discussion among participants, addressing topics such as the integration of innovative PPE technologies, adherence to evolving safety regulations, and strategies for mitigating risks to both healthcare professionals and patients.

This report provides an overview of keynote speeches and panel sessions at the third annual Safety For All Conference at the Royal College of Physicians in London on Tuesday 10 December 2024 The Safety For All campaign is focused on driving improvements in and between healthcare worker safety and patient safety. It seeks to highlight how poor staff safety standards and practice impact adversely on patient safety, and vice versa. The campaign champions the need for a systematic and integrated approach to improve safety for staff and patients across health and social care. Safety For All is jointly coordinated by the Safer Healthcare and Biosafety Network and Patient Safety Learning, supported by Boston Scientific and Stryker. The event was chaired by Professor Rob Galloway, Accident and Emergency Consultant at the University Hospitals Sussex NHS Trust. It was attended by over 100 members of the healthcare community, including occupational health professionals, patient safety experts, frontline staff, patients and academics. The report includes summaries of the conference’s speeches by: Professor Nicola Ranger, Chief Executive of the Royal College of Nursing Jane Murkin, Deputy Director Safety and Improvement – Nursing Directorate at NHS England. It also provides an overview of the following panel sessions across the day: Protecting lives while protecting the planet. Navigating the many faces of violence in healthcare. Caring for caregivers and patients – Mental health and safety in healthcare. Antimicrobial Resistance – Ensuring patient safety in an era of rising resistance. Implementing the Patient Safety Incident Response Framework. Throughout the speeches and panel discussions that ran across the day, there were several recurring themes: The important role of leadership in improving staff safety and patient safety. This being cited as the key to creating safer organisational cultures, modelling safety behaviours and advocating on behalf of patients and staff. The need for healthcare workers and patients to speak up in order to create a safer healthcare system, and the challenges of empowering staff to do this and organisations to create safety cultures in a system under significant strain. Communication and engagement is key – with staff and patients, and in convening people so they can collaborate for safety. Listening was mentioned throughout as being seen as a luxury, but it is essential to providing person-centred care. The challenge of sharing and spreading patient and staff safety initiatives when healthcare workers don't have time/capacity beyond trying to do the day job.

This report presents the first cross-sectional analysis of quality of care and patient safety in the World Health Organization (WHO) European Region. It is based on an analysis of macro-level data from international sources and the results of a WHO survey conducted in 53 Member States. Critical gaps identified include limited implementation of national action plans and policies for quality of care and patient safety and wide variations in indicator outcomes for dimensions of quality of care, health system functions and population health outcomes across the region. Key findings in this report included: A scaling up of implemented national action plans for quality and patient safety, including a demonstration of learning and continuous improvement of better practices, processes and outcomes, is needed in the majority of countries. Only one third of countries implemented both a national quality of care and patient safety action plan. Hospital accreditation systems are implemented in only a minority of countries, hindered by a limited availability of evidence, particularly on their cost-effectiveness. Antimicrobial resistance (AMR) plans are widely available in countries, but ample opportunities remain to combat AMR. The majority of countries (79%) have implemented an AMR plan, but persistent disparities in AMR prevalence for Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) remain across the region. Patient or public representation in national health governance is nearly non-existent, with only 13% of countries using this policy mechanism. Health misinformation prevention plans are absent in nearly all countries. Only four countries reported the use of a health misinformation plan. Such plans are important because they allow countries to deal effectively with infodemics during emergencies, including disease outbreaks, as well as with behaviours related to immunization adherence and noncommunicable diseases. The scarcity of the health and care workforce has significant consequences for the delivery of high-quality care. A limited number of countries have a national approved priority/essential medical devices list. Data show that only 22 countries have a national list of approved priority/essential devices. Electronic health records (EHR) are implemented in a low number of countries, jeopardizing the effective uptake of quality improvement interventions. Less than three quarters of countries (70%) reported having implemented EHRs, with only 13% having guidelines for quality and safety in telehealth. Patient safety-related indicators suggest a need for improvement with a high number of patient-reported medical mistakes. People-centredness indicators highlight important gaps in data collection on patient-reported outcome measures and experiences. Less than one third of the countries report on people-centredness indicators. Patient-reported outcome measures (PROMs) and experiences (PREMs) have important consequences for public confidence in the health system, health-care utilisation patterns, retention in care, and people’s decision to bypass facilities. Aggregated data mask inequalities within countries, showing a need for local systems of data collection and an evidence-base for equity-oriented policies. Poor population health outcomes highlight the need for a life-course approach and intersectoral action taking a quality of care perspective on the health of individuals and generations. Policy actions Based on the findings of the survey and towards addressing some of the challenges revealed across countries, a number of prospective actions to promote and/or ensure quality of care and patient safety emerge from the analysis. Invest in whole-system quality that comprises integrated quality planning, quality control, and quality improvement activities. Invest in the development of national action plans and policies for quality of care and patient safety. Develop a harmonised set of indicators for measuring and continuously improving quality of care, including measures that matter most to patients. Ensure patient and public representation in national health governance. Establish clear, evidence-based standards for all care settings. Re-design models of care around the needs and preferences of patients. Invest in an health and care workforce with the capacity and capability to meet the demands and needs of the population for high-quality care. Invest in robust public budgeting for quality of care and reconfigure payments to incentivise value in health service delivery. Develop comprehensive and multistakeholder-led biotechnology sector policies to address quality and affordability for patients and health-care systems. Invest in digital health solutions that support quality of care.