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In February, Public Policy Projects (PPP) 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. A wide-ranging conversation between Penny Dash, Chair of NHS England, and the PPP Chair, the Rt Hon. Stephen Dorrell, offered a rare, candid look at the thinking behind the forthcoming National Quality Strategy and the complex trade-offs shaping it. The session was a live debate on the priorities, pressures and realities of improving care across the NHS. In this blog, Patient Safety Learning reflects on the key takeaways from this keynote session. A strategy nearing the finish line Penny Dash confirmed that the National Quality Strategy is in its final stages, with publication anticipated in April 2026. The process has involved extensive input from across the system, with the National Quality Board—co-chaired with the Care Quality Commission—playing a central role in refining the final draft. While the timeline reflects urgency, it also highlights the challenge of aligning political, clinical, and operational perspectives in a single framework. However, there was a concerning lack of focus on the NHS Patient Safety Strategy. Will it be updated or subsumed into the National Quality Strategy? This interview made it clear that while patient safety may have become less of a focus for NHS leadership, for the delegates in the room it was front and centre. During a panel session earlier in the day, Bola Owolabi (CQC Chief Inspector of Primary Care and Community Services) had a clear focus on patient safety, saying that we are all patient safety practitioners and that interfaces between episodes of care are the biggest patient safety risk, with many patients falling between the cracks. Did we witness a complete difference of opinion and priority between key senior NHS leaders and, if so, what hope is there for coherent strategies that will align to bring safer care and improvements? No surprises—but a sharper focus At its core, the strategy reaffirms three familiar pillars of quality: Effectiveness (outcomes). Safety. Patient and user experience. But what matters is how these are prioritised. Penny Dash was clear that improving life expectancy and healthy life expectancy is the overarching goal. That means focusing on major drivers of population health, particularly cardiovascular disease and cancer, while aligning with broader NHS reforms around prevention, community care and digital transformation. The big insight: effectiveness versus safety One of the most striking moments came when Dash revisited a controversial finding from her earlier review: Improving effectiveness could save ~100,000 lives per year. Improving safety could save between 1,000 and 10,000. Her message was clear: this is not a choice, but it does challenge how the system has historically prioritised safety over other aspects of quality and the outcomes from that; aspects of patient safety have not improved over the past 25 years. Audience members pushed back on this framing, arguing that safety and effectiveness are often intertwined in practice. Penny Dash agreed, acknowledging that quality cannot be meaningfully separated into silos and should instead be addressed as a whole. A system out of balance Penny Dash also pointed to a deeper structural issue: how resources have been allocated across the NHS. Over the past decade: Hospital spending has risen significantly. Primary care has seen modest growth. Community care funding has declined. At the same time, life expectancy and healthy life expectancy have fallen. The implication is stark: the system may be investing heavily, but not always in the areas that deliver the greatest long-term health impact, reinforcing the need to prioritise prevention, neighbourhood care and earlier intervention. The role of Integrated Care Boards Integrated Care Boards (ICBs) were highlighted as critical to delivering change. Their role is to: Plan services for local populations. Improve outcomes and reduce inequalities. Ensure value for money. Penny Dash emphasised that ICBs must take responsibility for entire populations, including underserved groups such as prisoners and the homeless, while being supported by national guidance and shared best practice. As ICBs implement more strategic commissioning, the performance management of the outcomes will fall to the regions. Given the current situation with resource reductions and redundancies, will anyone be focussing on ensuring the right staff are in place with the right skills to understand safety indicators and analyse the data? A lack of appropriate people in place who understand this agenda will leave a void, meaning we will see no progress in how the available data is used to review implementations, learn lessons and make improvements. Patient experience: leadership without mandates A major proposal within the strategy is the creation of a National Director of Patient Experience, aimed at strengthening how patient feedback informs decision making. However, this sparked debate around a broader theme: the approach of not mandating process and practice across the NHS. The perspective from Penny Dash was that too many mandates can stifle innovation and local responsiveness; however, too few can lead to inconsistency and inaction. Rather than imposing roles or structures from the centre, the strategy will lean towards defining best practice and encouraging adoption locally—a move that drew both support and scepticism from the audience. Patient Safety Learning has recently highlighted through our blogs the concerns that the patient voice is being dissipated given the structural changes resultant from the implementation of the Dash review. We will look to support initiatives strengthening the patient voice that might come from the new National Director of Patient Experience. Technology as a game changer Another key theme from the keynote was the role of technology, particularly through Modern Service Frameworks. Unlike traditional guidelines, these are envisioned as live, digital tools that will integrate with patient records with the ability to provide real-time prompts to clinicians. Early focus areas include cardiovascular disease and sepsis, with ambitions to expand into mental health, frailty and children’s services. If successful, this could mark a shift from static policy documents to dynamic, data-driven care pathways. Beyond healthcare: the wider determinants The discussion also touched on the limits of the NHS alone in improving health outcomes. Penny Dash highlighted the importance of social prescribing, housing and legal support, and community and mental health services. These 'non-biomedical' interventions are increasingly recognised as essential but require closer collaboration between the NHS, local authorities and public health systems. The mandate dilemma—still unresolved Perhaps the most persistent theme throughout the session was the unresolved tension between national consistency and local autonomy. As the chair noted, this is “as old as the health service” itself. Dash’s position was pragmatic: neither extreme work. The challenge is to find a balance that ensures high standards across the country while allowing local systems the flexibility to innovate and respond to their populations. Audience Q&A Members of the audience were given the opportunity to pose questions to Penny. Following a comment from her, that our collective focus should have been on quality rather than patient safety, there was a noticeable edge to delegate’s questions. People were surprised that patient safety appeared to have been downgraded in importance and others seemed to question whether NHS senior leaders are in tune with the reality of frontline work. Some felt this was not a positive demonstration of leadership in a time of significant change within the NHS. A system in transition The conversation made one thing clear: the National Quality Strategy is not just a document, it’s an attempt to reshape how the NHS thinks about quality, signalling a shift from safety alone → to broader outcomes, from central control → to guided collaboration and from static policies → to dynamic, tech-enabled systems. But it also exposes the scale of the challenge. Balancing priorities, reallocating resources, integrating services and maintaining public trust all while improving outcomes will require more than strategy alone. It will require sustained alignment across one of the most complex healthcare systems in the world. And as this session showed, that conversation is only just getting started. At Patient Safety Learning, we look forward to the publication of the National Quality Strategy. We will reflect and engage with our network members before publishing on the implications for patient safety. 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: Safe systems, safe cultures: reflections from the Patient Safety Forum 2026 Patient voice, safety and the NHS 10 Year Plan: Reflections from the Patient Safety Forum 2026 Designing AI with patient safety at its core: Reflections from the Patient Safety Forum 2026

Unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. WHO Patient Safety Flagship has initiated a series of monthly webinars on the topic of “WHO Global Patient Safety Challenge: Medication Without Harm”,. The main objective of the webinar series is support implementation of this WHO Global Patient Safety Challenge: Medication Without Harm at the country level. Considering the huge burden of medication-related harm, Medication Safety has also been selected as the theme for World Patient Safety Day 2022. With each transition of care (as patients move between health providers and settings), patients are vulnerable to changes, including changes in their healthcare team, health status, and medications. Discrepancies and miscommunication are common and lead to serious medication errors, especially during hospital admission and discharge. Countries and organizations need to optimise patient safety as patients navigate the healthcare system by setting long-term leadership commitment, defining goals to improve medication safety at transition points of care, developing a strategic plan with short- and long-term objectives, and establishing structures to ensure goals are achieved. At this webinar, you will be introduced to the WHO technical report on “Medication Safety in Transitions of Care,” including the key strategies for improving medication safety during transitions of care. Register

This conference focuses on Prehabilitation – Principles and Practice, and will provide a practical guide to delivering an effective prehabilitation programme, ensuring patients are fit and optimised for surgery/treatment. This is even more important in light of the Covid-19 pandemic and lockdowns which have had a negative effect on many individual’s health and fitness levels, and currently high waiting lists could be used as preparation time to ensure the best outcomes. The conference will look at preoperative/pre treatment optimisation of patients fitness and wellbeing through exercise, nutrition and psychological support. This conference will enable you to: Network with colleagues who are working to deliver effective prehabilitation for surgery/treatment Reflect on a patient lived experience to understand how to engage patients in prehab programmes Learn from outstanding practice in implementing a prehabilitation programme Embed virtual prehabilitation into your programme during and beyond Covid-19 Demonstrate a business case for prehabilitation and ensure prehab services continue through and beyond the pandemic Reflect on national developments and learning Improve the way we support patients to prepare themselves, physically and emotionally for surgery/treatment Develop your skills in Behaviour Change and Motivational Interviewing Embed virtual prehabilitation into your programme during and beyond Covid-19 Learn from case studies Understand how you can improve emotional and psychological support Explore the role of prehabilitation in older people Work with patients to improve nutrition Ensure you are up to date with the latest evidence Self assess and reflect on your own practice Supports CPD professional development and acts as revalidation evidence. This course provides 5 Hrs training for CPD subject to peer group approval for revalidation purposes. Register

In order to support the NHS Priorities set out for 2022/2023 in delivering significantly more elective care to tackle the elective backlog and to reduce long waits, we take a look at the developing approaches to patient care using collaborations with providers delivering treatments in the home in order to support patient flow. This webinar will explore: How teams have innovated to provide hospital-at-home during the Covid-19 crisis and what’s needed to maintain the momentum of change? What is the future direction for hospital-at-home, post-pandemic, and what will accelerate or prevent adoption at scale? Evaluation and evidence required to support the case for change. Register

This conference will provide a practical guide to delivering an effective prehabilitation programme, ensuring patients are fit for cancer surgery or treatment. This is even more important in light of the COVID-19 pandemic and lockdowns which have had a negative effect on many individual’s health and fitness levels. The conference will look at optimisation of patients fitness and wellbeing through exercise, nutrition and psychological support. Register

The NHS spends £8.3 billion a year treating chronic wounds on an estimated 3.8 million people, according to the recently updated study evaluating the “Burden of Wounds” to the NHS. Costs have increased by 48% in the five years since the study was first published and the overwhelming majority of this burgeoning demand, around 80% of the caseload, impacts on community healthcare. This webinar will explore the “Burden of Wounds” with study author Julian Guest and consider how digital wound management solutions can relieve pressure and improve outcomes. We’ll see case studies from community nurses, hear the patient and staff view through #tvn2gether and the National Wound Care Strategy team will share their long term vision. Chaired by Margaret Kitching MBE, Chief Nurse for NHS England and NHS Improvement’s North East and Yorkshire Region, this conversation brings together leading voices within wound care to discuss new strategies for 2021 and beyond. Register

There are many sources of variation in healthcare that can affect the flow of patients through care systems. Reducing and managing variation enables systems to become more predictable and easier to manage so allowing improvement of quality and safety. To effect successful service improvements, you need to understand the source of variation and use a range of tools to reduce and manage it. This pandemic has provoked the best of human compassion and solidarity, but those who manage our health systems still face extraordinary challenges responding to COVID-19. Looking beyond the crisis, our collective learning about the effects of the large falls in healthcare use can help inform and intensify efforts to reduce unnecessary care. The aim of this webinar is to build a culture of collaborative working across the healthcare workforce and reduce variation to prevent avoidable harm to patients, enhance healthcare equity, and improve the sustainability of health systems everywhere. Register

In this Westminster Health Forum event, delegates will assess the priorities for improving lung health in England. Areas for discussion include: responding to the pandemic, and the challenges of long COVID lung health in the implementation of the NHS Long Term Plan optimising respiratory prescribing promoting prevention and addressing inequalities, including air quality improvement and developing healthy communities next steps for integrated respiratory care, rehabilitation and care at a local level research, innovation and priorities for service transformation. Register

One of the great opportunities for ICSs may be around reducing future demand for healthcare by ensuring that people remain healthy or are helped to reduce the chances of deteriorating if they do develop an illness or long-term condition. Prevention and early intervention underlie much of the NHS Long Term Plan, with a recognition that the NHS can no longer simply be an “ill health” service and instead bends to think about prevention and reducing health inequalities. Many ICSs are keen to develop this role and bring together the organisations they represent – across both the NHS and local authorities –to work collaboratively on this. But with resources and time limited, they may need to concentrate their efforts on particular areas. The second wave of covid – and the prospect of widespread vaccination starting within weeks - has added a new dimension to this with an urgent need to reduce the pressure covid places on the NHS and on normal life in general. This webinar will ask: has covid helped focus the NHS’s eyes on prevention? where are the “easy wins” for ICSs where interventions are most likely to have significant results within a reasonable timeframe? what key steps do ICSs need to take to get the maximum benefit from these? How can they build common purpose among their members to ensure these happen? how can public health be made “business as usual” for everyone working in the NHS – including those in hospitals? how can ICSs balance the preventative interventions which deliver short-term benefits with those which take longer to offer a “return on investment”? Register