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Content ArticleWhy does joining up health and social care still feel so difficult in practice? And what does that mean for people navigating both systems? This long read from the King's Fund sheds light on the ‘no man’s land’ many experience at the interface between health and social care, revealing the deeper structural issues behind delays, fragmented support and growing pressure on patients and carers.
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Content Article
In manufacturing a missed signal can cost a product, but in healthcare it can cost a life. In this blog, Annette Cairns, a leadership development specialist, asks how we can adapt the system-level thinking seen in manufacturing for the unique human complexity, variability and vulnerability that patient care brings. In manufacturing, there was a moment—and you can trace it back through aviation, oil and gas and automotive—when the conversation about safety changed fundamentally. It stopped being about finding the person who made the mistake, and started being about understanding the system that allowed the mistake to happen. That change didn’t come easily or by any means quickly. It required organisations to accept an uncomfortable truth: that in complex, high-pressure environments, human error isn’t primarily a sign of individual failing. It’s a predictable consequence of how systems are designed, how cultures are shaped and how leadership behaves in the moments that really count. The results, where that change has genuinely taken root, have been significant. Aviation is the most cited example—an industry that rebuilt its entire safety culture around the principle that hierarchy, in a cockpit or control tower, cannot be allowed to silence a concern. Crew Resource Management gave co-pilots not just permission but a structured obligation to speak up, regardless of seniority. Near-miss reporting removed the threat of punishment from honesty. Safety culture became something designed into the system, not dependent on the courage of individuals. In manufacturing, parallel principles emerged. James Reason’s Swiss Cheese model gave organisations a language for understanding that failures are almost never caused by one person, but instead they happen when holes in multiple defensive layers happen to align. Toyota’s production system gave every worker on the line the ability to stop everything the moment something didn’t look right. The message was clear and consistent: the system is designed to receive your concern. You don’t need to be brave to raise it. Speaking up is what we do here. Healthcare has borrowed much of this thinking, and rightly so. Just Culture principles, incident reporting frameworks, the language of human factors, all have roots in what manufacturing and aviation learned the hard way over decades. And yet a significant gap remains. It sits not within the clinical team, but between the clinical team and the patient. This is where healthcare faces a layer of complexity that manufacturing simply does not. In manufacturing, the subject of a safety concern, whether it’s the process, the component or the output, has no psychological state. It isn’t frightened. It doesn’t defer to the expertise of the people responsible for it. It has no uncertainty about what ‘normal’ feels like, no anxiety that raising a concern might result in worse treatment, no cultural background or language barrier that makes speaking up feel impossible or unsafe. A patient has all of these things. And they have them at the precise moment they are most vulnerable, most dependent on others and are least certain of their own ground. They are, in the truest sense, inside the system they are being asked to influence. That is a profoundly different position from a worker who can step back from a production line and raise a concern from a position of relative stability. When a patient stays silent about something that concerns them, they are rarely choosing silence because they lack information or awareness. They are making a calculation (often unconsciously) based on the culture they are experiencing: the responsiveness of the people around them, the signals they have received about whether their voice is genuinely welcome, and the very human fear that being perceived as ‘difficult’ might affect the quality of their care. In a system where patients feel they must be compliant to be safe, we have already failed at the most fundamental level. Traditionally, healthcare has tried the route of patient education, but you cannot close this gap just by training patients to be more assertive or by producing better information leaflets about how to raise concerns. It is an organisational and leadership problem—and I believe one that requires the same system-level thinking that transformed safety culture in manufacturing. It requires leaders who understand that psychological safety for patients is not a clinical add-on. It is a core organisational competency. Leaders who ask not just "did we give the patient an opportunity to speak?" but "have we genuinely designed a system in which speaking up is the path of least resistance—and in which our teams have the skills and the capacity to hear what patients say, and act on it?" My extensive work on health and safety behaviour change in manufacturing and technical organisations has consistently shown that the leadership behaviours which create safety: active listening, psychological safety, the reward of raising concerns rather than resolving them quietly, are not industry-specific. They are human. What is industry-specific is the stakes when those behaviours are absent. In manufacturing, a missed signal can cost a product. In healthcare, it can cost a life. The framework for getting this right already exists. Manufacturing and aviation built it over decades of hard-won experience. The question for healthcare is not whether to adopt this system-level thinking, but how to adapt it for the unique human complexity, variability and vulnerability that patient care brings. That work starts with leadership. It always does. -
Content ArticleThis evidence review aims to examine what it feels like to experience ‘well-led’ health and/or care services and organisations, from the perspectives of people with lived experience and people working in health and social care. It is an extension to ‘Making it Real’ - a framework and set of statements co-produced by Think Local Act Personal (TLAP) and the Care Quality Commission (CQC) that describe what good, co-ordinated and personalised care and support look like from the perspective of people drawing on it.
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Content ArticleThe massive roll-out of new and repurposed medicines in low-income and middle-income countries (LMICs) highlights the need for more efficient pharmacovigilance systems, including use of digital technologies. This study reports a large pragmatic cluster-randomised controlled trial to assess the effectiveness of the smartphone app Med Safety in improving suspected adverse drug reaction (ADR) reporting by healthcare workers to Uganda's National Pharmacovigilance Centre. Between Aug 11, 2020 and Nov 1, 2022, 367 clusters (healthcare facilities providing dolutegravir-based combination antiretroviral therapy in Uganda) received the allocated intervention (184 in the intervention group and 183 in the control group), with 2464 health-care workers (1211 in the intervention group and 1253 in the control group). In the intervention group, health-care workers received pharmacist-delivered training in Med Safety and traditional ADR reporting methods. The control group received the same training as the intervention group except for Med Safety training. The primary outcome was the cluster-level ADR reporting rate at the end of follow-up (at least 12 months) and was analysed in all sites that received the allocated intervention. Med Safety use was found to increase ADR reporting rates among health-care workers in Uganda, particularly non-serious and dolutegravir-related ADRs. These findings suggest that integrating digital technologies into pharmacovigilance systems could strengthen drug-safety monitoring in Uganda and other LMICs.
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Content Article
Core Needs project (neurodivergence)
Craig.russo posted an article in Innovation programmes in health and care
Craig Russo outlines the Core Needs School Pilot, a needs-led, school-based early intervention model for young people with neurodevelopmental needs. He describes how embedding clinicians in schools enables rapid, functional assessment and support without waiting for diagnosis, improving outcomes while significantly reducing costs and demand on specialist services. It demonstrates impact and support expansion, highlighting strong value for money, improved access and alignment with national SEND reform principles. The Core Needs provides a clear, practical example of how a needs‑led model can be operationalised at scale within mainstream education, moving beyond theory into delivery. It demonstrates how embedding clinical expertise directly into schools transforms access, shifting support closer to children and young people and enabling real-time assessment, observation and intervention in their everyday environment. This approach not only improves timeliness but strengthens relationships between health, education and families, creating a more joined-up system that is easier to navigate. A key learning point is the power of intervening early with functional, strengths-based support rather than relying on diagnostic thresholds. The model shows that many young people can be effectively supported through a single, well-structured intervention, supported by a period of watchful waiting and clear step-up pathways when required. This has important implications for demand management, demonstrating a credible route to reducing pressure on specialist services while maintaining safe and appropriate escalation. The pilot also highlights the importance of building capability within schools. By working alongside SENCOs and staff, clinicians are not only supporting individual children but leaving a lasting legacy of increased confidence, skills and consistency within the wider workforce. This creates a multiplier effect, where impact extends beyond the initial intervention and contributes to longer-term system resilience. From an operational perspective, the pilot identifies critical enablers of success, including strong multi-agency partnership working, clear referral processes, dedicated workforce capacity and a structured delivery model. It also makes clear the risks of not investing, particularly around increasing demand, widening inequity of access and continued reliance on costly statutory pathways. For decision-makers, the key action is to consider how this model can be embedded as part of the core local offer, rather than as a time-limited pilot. The evidence presented supports scaling through a phased approach, ensuring quality and consistency are maintained while expanding reach. It also prompts a wider reflection on how services can redesign pathways to prioritise early intervention, improve flow and ensure that resources are directed where they have the greatest impact. Overall, this pilot offers a compelling, evidence-informed case for system change, showing not just what should be done differently, but how it can be delivered in practice in a way that is sustainable, equitable and centred on the needs of children and young people. More blogs on the hub from Craig Russo: Partnership working between A&E, the police and custody healthcare -
Content Article
A recent white paper, Clinical Competency in the Age of AI, presents findings from a systematic narrative synthesis of 445 studies examining clinical competency requirements in AI-augmented healthcare. It addresses a structural gap in how current competency frameworks prepare clinicians for AI-assisted practice. In addition to examining the breadth of research into clinical risks associated with use of AI in clinical care, the research analysed 23 existing AI competency and capability frameworks, including the NHS Health Education England AI and Digital Healthcare Technologies Capability Framework and the DECODE international consensus framework. It found that across all reviewed frameworks, the competencies most critical for frontline patient safety—critical appraisal of AI recommendations, detection of biased outputs, governance escalation, and protection of professional moral accountability—are largely limited to awareness statements for frontline users. Clinicians are expected to understand what AI is. They are not equipped to practise safely with it. The white paper proposes a five-domain competency framework, specified across three career stages, that translates intersecting AI risks into assessable clinical capabilities for practising clinicians. Key findings AI erodes clinical reasoning without competency safeguards. The Budzyń et al. (2025) multicentre colonoscopy study provides the first real-world evidence: adenoma detection rates fell from 28% to 22% among endoscopists after three months of AI assistance. The skill had not been assessed. It had not been exercised. It had atrophied. Cognitive overload drives uncritical AI acceptance. Alert override rates of 90–96% have been documented in deployed clinical AI environments—a workforce adapting to unsustainable demand by reducing evaluative effort. AI tools assessed as safe under controlled conditions carry significantly higher risk in busy, overstretched environments where they are most needed. Governance infrastructure is inadequate. Over 70% of NHS trusts lack documented clinical safety assurance for deployed AI tools (Oskrochi et al., 2025). Clinicians in these settings carry full personal professional accountability for AI-assisted decisions without the institutional infrastructure that should underpin them. Risks compound, but are treated as parallel separate risks. Time pressure increases automation bias severity. Automation bias accelerates deskilling. Deskilling undermines safety governance capacity. Equity failures concentrate where burnout is highest and training resources most limited. Current frameworks miss these feedback loops. Healthcare-specific competency frameworks are insufficient. Over 75% of medical students receive no formal AI education. Where training exists, assessment tools lack specificity for healthcare contexts. This research defines what AI clinical competency requires: technical understanding, critical appraisal, equity awareness, safety governance knowledge, and professional identity maintenance, integrated rather than treated as separate modules. Implementation guidance remains fragmented. Governance frameworks address safety. Education frameworks address training. Workforce research addresses burnout. Each treats its domain rigorously while missing the system dynamics. This research consolidates evidence into practical principles for curriculum development, organisational deployment and regulatory strengthening. Harm concentrates in those least able to detect it. The populations most at risk from biased AI outputs are served by clinicians least equipped to recognise that bias, in settings least able to monitor it. This convergence is structural and will not be resolved by improving AI performance alone. -
Content ArticleQualitative research methods explore and provide deep contextual understanding of real world issues, including people’s beliefs, perspectives, and experiences. Whether through analysis of interviews, focus groups, structured observation, or multimedia data, qualitative methods offer unique insights in applied health services research that other approaches cannot deliver. However, many clinicians and researchers hesitate to use these methods, or might not use them effectively, which can leave relevant areas of inquiry inadequately explored. Thematic analysis is one of the most common and flexible methods to examine qualitative data collected in health services research. This article offers practical thematic analysis as a step-by-step approach to qualitative analysis for health services researchers, with a focus on accessibility for patients, care partners, clinicians, and others new to thematic analysis. Along with detailed instructions covering three steps of reading, coding, and theming, the article includes additional novel and practical guidance on how to draft effective codes, conduct a thematic analysis session, and develop meaningful themes. This approach aims to improve consistency and rigor in thematic analysis, while also making this method more accessible for multidisciplinary research teams.
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News ArticleFewer and fewer Americans can afford healthcare and the situation has reached a “crisis point,” according to an urgent warning from the American Heart Association. And with total healthcare spending expected to account for 20 percent of the nation’s gross domestic product over the coming decade, people could feel even more financial pain, medical experts cautioned Thursday. Total healthcare spending by U.S. adults currently sits at $5 trillion annually, driven largely by chronic disease, the association’s advisory said. Rising costs often mean that people will forgo initial care, increasing the likelihood for more serious problems and therefore greater costs down the road. The American Heart Association identified some causes behind people’s rising healthcare costs as complex administration at facilities, and a lack of investment in prevention and public health across the U.S. The doctors called on lawmakers and the healthcare industry to address the crisis. Read full story Source: The Independent, 30 April 2026
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Content Article
Protocols, targets and pathways save lives. They give us essential structure to deliver safe, high‑volume care with finite resources, and they have transformed the NHS for the better. But as the healthcare experience becomes increasingly streamlined, Hannah Little, Assistant Chief Nursing Officer at North Bristol NHS Trust, asks: who are we leaving behind? One size rarely fits all We often hear about what healthcare can learn from efficiency‑led industries such as automotive manufacturing, where success is defined by pace, scale and uniform outcomes. And indeed, cross‑industry learning has benefited the NHS enormously. But context matters. People are not cars rolling off a production line. We are complex, diverse human beings with individual social, psychological and clinical needs. And I wonder how far we can push a target‑driven model before we start hearing louder public concern about the fact that, in healthcare, one size rarely fits all. Finding the sweet spot As a nurse, I see individuals deliver personalised care brilliantly. I see colleagues who instinctively adapt, interpret and flex protocols to truly meet the needs of their patients and families. What worries me is not the people—it’s systems that increasingly constrains them. There is a 'sweet spot' between regulation, targets and national mandate on one side, and freedom to innovate on the other. That tension is necessary: too much control and we lose space for creativity; too little and we invite unsafe variation. When the balance is right, systems evolve safely, testing change within a clear structure while allowing for the flexibility that person‑centred care requires. The weight of national targets Standards and strong governance are essential to quality. But how do we ensure they don’t swallow the space needed for anything else? Over recent decades, the weight of national targets has grown heavier. The NHS Oversight Framework was intended to bring much‑needed clarity—a more focused set of national priorities that would reduce noise and strengthen local autonomy. At the 2026 Patient Safety Forum, national leaders spoke about a welcome cultural shift away from over‑mandating and toward local devolution. But this shift appears to be landing alongside a net reduction in resource and ever higher stakes to deliver. So instead of fewer mandates and more autonomy, we may be facing fewer mandates and less capacity for innovation. This raises a critical question: after the targets are met, is there enough resource left for the other things that matter? The things that support sustained performance? Targets tend to serve the 80% who fit neatly onto the healthcare conveyor belt. Without additional support for those who don’t, we risk widening health inequalities. Equity requires adaptability to be hard-wired into pathways—and adaptability requires headroom. The trade-offs Are we comfortable with where we are now? Has the pendulum swung into the place we need for 2026? Everyone recognises that resources are limited. But when limited resources necessitate laser focus on a small number of priorities, are the trade‑offs services have to make the right ones for population health? What will we think, looking back in five to ten years? Will we feel confident that a model which rewards optimising delivery for the majority was worth potentially widening the gap for those who didn’t fit standard pathways? Unlike other industries (e.g. Apple, which famously narrowed its product line to recover focus), healthcare cannot simply do fewer things well. Complex populations do not disappear because they fall outside a national priority. When centrally governed targets narrow without a corresponding rise in local capacity, the burden of adapting care falls to already stretched individuals. And when that happens, quality, equity and outcomes inevitably feel the strain. So what is the solution? If we care about equity and the safety and health of whole populations, resource to adapt and personalise care needs to be preserved. We need open, honest analysis of the trade-offs being made at policy level. Do we have the right set of priorities? Are we incentivising organisations to only pick low‑hanging fruit? And crucially: are we preserving the resource required to deliver personalised, equitable care? Passionate individuals cannot carry this burden alone. Flexibility must be designed into the system, not left to chance. And perhaps the answer is not fewer targets—but targets that incentivise equity as much as efficiency. Call to action Policymakers and senior leaders must prioritise embedding flexibility within national frameworks for all sectors by protecting resource for personalised care, incentivising equity alongside efficiency and enabling local systems to adapt. Without deliberate action, we risk incentivising services that work well for many, but fail those most in need. -
Content ArticleThis Health Service Safety Investigations Body (HSSIB) investigation focuses on how the health needs of people in prison are assessed and the provision of safe living conditions for people in prison who use a wheelchair or have mobility issues. This investigation explored how healthcare provision for a whole prison’s population is assessed and commissioned using health needs assessments. How outdated assessments may present a patient safety risk through mismatched staffing skill mix and services that don’t match the patient’s needs. These risks may result in physical injuries, psychological distress and dignity violations, each of which can impact on patient wellbeing. It looked at challenges related to this approach, cost implications of the current system and ongoing developments. Disability access within prisons is complicated by the original design and purpose of prison buildings. Some of the prison estate dates back as far as 1800, making adaptations and provision for wheelchair users, for example, difficult. The investigation explored the prevalence of this issue, the impact on people in prison and potential areas for improvement. Findings The investigation explored two main themes: health needs assessments and access for physically disabled people within prisons. These themes were identified during the evidence gathering phase for the three previous HSSIB reports in this series. The findings have been separated into these two themes and are listed below: Health needs assessments (HNAs) The current process of developing an HNA for a prison population, which are generally conducted at most every 3 years, means that HNAs are frequently out of date by the time they inform commissioning decisions. There is often a delay in prison healthcare providers being made aware of likely changes to the prison population by HM Prison and Probation Service (HMPPS). This can impact on providers’ ability to ensure the required healthcare provision is in place to serve the new population. Outdated HNAs lead to mismatched healthcare provision, forcing providers to submit business cases for additional services or absorb the financial impact of changes to their services. The business case processes were slow and did not support the needs of a rapidly changing prison population, resulting in services that may pose patient safety risks due to mismatched healthcare services, incorrect staff skill mix requiring retraining, recruitment, and removal/addition of new services. HNAs were commissioned by NHS England regional commissioning teams and did not include social care requirements as this is commissioned by local authorities, which made planning and provision of social care difficult and often resulted in delays in care. In response to limitations in the current HNA process, some regions had introduced alternative approaches, including digital data dashboards and artificial‑intelligence‑enabled tools. Different approaches to assessing healthcare requirements for prison populations contributed to variation in how healthcare services were commissioned and delivered across the prison estate. Stakeholder engagement in assessing prison population health requirements was limited; local authorities and other relevant bodies were rarely consulted, contrary to guidance. Physical disability access Wheelchair users experienced harm and dignity concerns, including injuries from unsafe chair-to-chair transfers and deteriorating mental health caused by being housed in inappropriate accommodation. The number of wheelchair users in prisons is increasing, and many prisons cannot easily accommodate wheelchair users or people with mobility issues. None of the prisons visited had enough wheelchair-accessible cells. In some regions there were none. Accessible cells are sometimes located only on vulnerable prisoner wings, potentially wrongly associating wheelchair users with that cohort of prisoners. The current system for gathering information on the physical accommodation needs of people in prison is ineffective; this can impact on the ability to place people in appropriate accommodation. HSSIB makes the following safety recommendations HSSIB recommends that HM Prison and Probation Service, in collaboration with the Department of Health and Social Care, formalises arrangements for alerting healthcare commissioners and providers to changes in prison populations likely to impact on healthcare provision requirements. This is to ensure that healthcare commissioners and providers can plan for changes to healthcare services that are necessary to meet the changing needs of the prison population. HSSIB recommends that the Department of Health and Social Care works with local authorities to redesign how the health and social care needs of prisons’ populations are assessed. This is to ensure that appropriate services are commissioned to meet the needs of people in prison and prevent possible delays in care. HSSIB recommends that HM Prison and Probation Service reviews and amends its information gathering processes for accommodation requirements for wheelchair users and people with mobility issues, to identify and mitigate risks for people whose accommodation does not meet their needs. This is to enable and support the effective identification of appropriate prison accommodation for these groups.
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Event
HLTH Europe
Sam posted an event in Community Calendar
HLTH Europe 2026 is the continent’s largest healthcare innovation conference, bringing together over 5,000 attendees from more than 50 countries. The event focuses on digital health, health tech, life sciences, and healthcare system transformation, providing a platform for decision-makers, innovators, and specialists to explore trends, solutions, and collaborations in European healthcare. The conference features a comprehensive programme, including: Keynotes and panels on healthcare IT, patient data exchange, AI in healthcare, interoperability, mental health, healthy ageing, and system change. Workshops and presentations led by industry leaders and experts. Networking opportunities with healthcare providers, policymakers, investors, pharmaceutical companies, tech companies, hospitals, and start-ups. Exhibition zones such as the Start-up Village, Investor Lounge, Policy Pavilion, and the NL Health~Holland Pavilion showcasing Dutch health tech innovations. Agenda Clive Flashman, Patient Safety Learning's Chief Digital Officer, will be leading a panel at the conference on Thursday 18 June on 'Blind trust: What happens to medical misinformation when we can no longer trust our own eyes?' Find out more. Register for the event here -
Content ArticleThe NHS has seen a 6 percentage point increase in public satisfaction, the first rise since 2019, according to the latest findings from the gold-standard survey of public attitudes to the NHS and social care, analysed by the Nuffield Trust and The King’s Fund and surveyed by NatCen. Key findings Satisfaction with the NHS In 2025, 26% of British adults were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs – a statistically significant 6 percentage point increase from 2024. Around half of respondents (51%) were dissatisfied with the NHS in 2025, a statistically significant fall of 8 percentage points compared to 2024 when it was 59%. This is the first increase in satisfaction since 2019, and the largest fall in dissatisfaction in more than 25 years. People under 35 (20%), supporters of Reform (20%) and people in Wales (18%) were significantly less satisfied with the NHS than the survey average. Despite the increase in satisfaction only 16% of respondents thought the standard of NHS care would improve in the next 5 years compared to 53% who said they expected care to get worse. Satisfaction with different NHS services Satisfaction with GP services was 35% and dissatisfaction was 45%. Neither was a statistically significant change on the previous year. Just over 1 in 5 respondents (22%) said they were satisfied with NHS dentistry, with 54% saying they were dissatisfied. These are similar results to the previous year. 22% of respondents said they were satisfied with A&E services. Dissatisfaction was 53%. In 2024, 19% said they were satisfied with A&E services, although the change is not statistically significant. 37% of respondents were satisfied with inpatient and outpatient hospital care, an increase of 5 percentage points since 2024, although not statistically significant. 29% were dissatisfied – no change on last year. Attitudes to NHS standards, access and staffing Half of respondents (50%) were satisfied with the quality of NHS care in 2025, and 28% were dissatisfied. There was no statistically significant change since 2024. Only a minority of respondents were satisfied with waiting times for GP appointments (27%), hospital appointments (16%) and in A&E (14%). There were no statistically significant changes compared to last year. Only 12% agreed that ‘there are enough staff in the NHS these days’. 71% disagreed. There was no significant change compared to 2024. Attitudes to NHS financing and efficiency 9% of respondents said that the government spent too much or far too much money on the NHS, 22% said that it spent about the right amount and 66% said that it spent too little or far too little. There were no statistically significant changes compared to 2024. Only 13% of respondents agreed that the NHS spends the money it has efficiently. 55% disagreed with this statement. There was no change compared to 2024. When asked about government choices on tax and spending on the NHS, the public remain closely divided between raising taxes and spending more on the NHS (45%) and keeping taxation and spending at the same level (43%). Only 8% would choose to cut taxes and spend less on the NHS. There was no statistically significant change since 2024. Supporters of the Green party (70%) and the Labour party (57%) were significantly more likely to support higher taxes and higher NHS spending than supporters of Reform (32%) and the Conservative party (30%). NHS priorities and principles On being asked what the top three most important priorities for the NHS should be, both making it easier to get a GP appointment and improving A&E waiting times were selected as top priorities by 46% of respondents, followed by 45% for waiting times for planned operations and 43% for increasing the number of NHS staff. People aged 18–64 were more likely than those aged 65 and over to prioritise A&E waiting times (48% vs 38%) and increasing NHS staff (46% vs 35%) whereas those aged 65 and over prioritised prevention and staying healthy (48% vs 36%). As in previous years, a large majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2025: that the NHS should be free of charge when you need to use it (89%), the NHS should primarily be funded through taxes (81%) and the NHS should be available to everyone (74%). There has been some decrease across the past five years in the proportion who think these principles should ‘definitely’ or ‘probably’ apply since the questions were first asked in 2021. The greatest decrease over time has been support for the principle that ‘the NHS should be available to everyone’. Support for the principle that the NHS should be available to everyone varied significantly by supporters of different political parties, with 68% of Labour supporters agreeing this principle should ‘definitely’ apply compared to 45% of Conservative supporters and 30% of Reform supporters. Social care In 2025, 14% of respondents said they were satisfied with social care. 49% were dissatisfied with social care – a statistically significant decrease from 2024 when this figure was 53%. The top three priorities for social care were helping people stay independent at home for as long as possible (46%), making social care more affordable to those who need it (45%) and improving the quality of social care services (44%). When asked about government choices on tax and spending on social care, 51% said the government should keep taxes and spending on social care at the same level as now. 38% said the government should increase taxes and spend more on social care. 6% said the government should reduce taxes and spend less on social care. Support for increasing taxes and spending more on social care was lower than for the NHS – it was 45% for the NHS. The difference was statistically significant.
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Content ArticleThe Covid-19 Inquiry published its third report and recommendations following its investigation into ‘the impact of the Covid-19 pandemic on the healthcare systems of the United Kingdom’ on Thursday 19 March 2026. It examines the governmental and societal response to Covid-19 as well as dissecting the impact that the pandemic had on healthcare systems, patients and healthcare workers. Recommendations There are many lessons to be learned from the experiences of the UK’s healthcare systems during the Covid-19 pandemic and many areas for improvement. The Inquiry has made 10 recommendations and considers them all to be necessary to prevent healthcare systems being overwhelmed in the next pandemic: Recommendation 1: Ensure that decision-making on infection prevention and control is underpinned by clear structures and a cautious approach to transmission risk The UK government must ensure that there is a body (equivalent to the UK Infection Prevention and Control Cell) in place ready to be convened at the outset of any future pandemic, to consider and draft infection prevention and control guidance for healthcare settings. This body must: have clear lines of responsibility and a clear, pre-defined role and remit during a pandemic have multidisciplinary membership, including experts in the science of viral transmission as well as those with clinical expertise ensure that its guidance accounts for the risk of all plausible routes of transmission until sufficient evidence emerges to rule out specific routes ensure that guidance clearly explains the underlying rationale for the precautions recommended. Separately, the Department of Health and Social Care, NHS National Services Scotland, Public Health Wales and the Public Health Agency (Northern Ireland) should review the national infection prevention and control manuals and any future guidance to ensure that the approach to identifying risk of transmission is not confined solely to specific procedures. Emphasis should be placed on a combination of risk factors, such as rates of transmissibility, environment, setting and procedure. Recommendation 2: Guidance for visiting restrictions The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should publish guidance for the implementation of visiting restrictions in hospitals in the event of a future pandemic. The guidance should identify the circumstances in which visiting restrictions should be introduced, escalated, decreased and removed alongside the measures and exemptions at each level. The guidance should be led by the following core principles: Measures applied should be the least restrictive possible, both in terms of severity and the length of time for which they apply. Restrictions should be decided upon and applied at the most local level possible. Unless restrictions are applied at a specified level, trusts and health boards should take decisions on the severity of restrictions based on local risk assessments. Communications with the public must clearly explain the measures in place and the reasons why restrictions apply. The guidance should be reviewed every three years in line with the Inquiry’s Module 1 Report (Recommendation 4) Recommendation 3: Better preparation for fit-testing The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with employers, including health boards and trusts, to review the availability of qualified fit testers and take steps to increase the number of fit testers accordingly. Availability should be reviewed every three years in line with the Inquiry’s Module 1 Report (Recommendation 4). The Health and Safety Executive and the Health and Safety Executive for Northern Ireland should update their guidance to employers to emphasise the need to ensure that sufficient fit-testing capacity is available. Recommendation 4: Improve data systems to identify individuals at high risk during a pandemic The UK government, Scottish Government, Welsh Government and Northern Ireland Executive must ensure that health data and digital systems have the capability to identify individuals at high risk of morbidity or mortality from a pandemic disease quickly and accurately in a future pandemic. This should include action to improve health data systems and patient record-keeping by: improving patient data by enabling more granular diagnostic coding ensuring that care records are compatible across primary and secondary care enabling secure data-sharing and linkage across multiple health datasets and systems for identifying individuals at high risk. Recommendation 5: Prepare to scale up urgent and emergency care capacity The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, in conjunction with organisations responsible for delivering services, should plan for surge capacity in urgent and emergency care during a pandemic. Plans must ensure that there is sufficient workforce capacity and the ability to surge, including the number and type of staff required, recruitment and training provision. This should be completed as part of the whole-system civil emergency strategy recommended in the Inquiry’s Module 1 Report (Recommendation 4). Plans should be published and subject to review every three years. Recommendation 6: Prepare for and test the ability to scale up hospital capacity The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with trusts and health boards to ensure that pandemic plans include practical steps to rapidly scale up hospital capacity to treat acutely unwell patients. This should include critical care services that can deliver multiple levels and types of organ support. It should also cover necessary equipment, supplies, space and staff, including redeployment and training. All trusts and health boards must keep an easily accessible, up-to-date record of the information needed to implement these plans in the hospital sites they operate. This should include technical aspects of critical care expansion such as power, ventilation, oxygen and waste management systems. Plans for expanding capacity should be published, subject to review every three years and tested as part of the pandemic response exercises recommended in the Inquiry’s Module 1 Report (Recommendation 6). Recommendation 7: A framework to guide the allocation of intensive care resources in the extreme event of saturation The UK government and devolved administrations should publish a UK-wide framework setting out ethical and operational principles to guide the allocation of adult intensive care resources in the extreme event that they are saturated during a pandemic. That framework must: be informed by comprehensive engagement with the public and developed in conjunction with professionals across healthcare, law and ethics, as well as with regulators of healthcare professionals set out clearly established triggers for its use, based at least in part on a UK-wide system that measures critical care capacity strain and facilitates mutual aid (such as the CRITCON tool used in England) establish clinicians’ legal and professional duties in applying the framework, which should be clearly explained to clinicians through guidance be regularly reviewed with reference to contemporary patient data during a pandemic, and any future use of it must be evaluated and reported on publicly. A plan and timeline for completing this work should be published within six months of this Report. Application of the framework should be tested as part of the pandemic response exercises recommended in the Inquiry’s Module 1 Report (Recommendation 6). Recommendation 8: Systematically recording and publishing healthcare worker deaths The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should work with their respective public health agencies and healthcare employers to develop nation-specific mechanisms to collect, analyse and publish data systematically on the deaths of healthcare workers in the event of a pandemic outbreak. The UK Statistics Authority should work with data providers to ensure that the data are comparable across the four nations of the UK. Recommendation 9: A standardised process for advance care planning across the UK The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, working with trusts and health boards, should establish and promote one standardised process across the UK (such as ReSPECT, the Recommended Summary Plan for Emergency Care and Treatment) for clinicians to ascertain and record their patients’ wishes and preferences for future care and treatment in order to inform individualised decision-making, including Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices. Recommendation 10: Psychological and emotional support for healthcare workers The UK government, Scottish Government, Welsh Government and Northern Ireland Executive, working with healthcare employers and professional bodies, should put in place plans to deliver effective support for healthcare workers at scale from the outset of a pandemic. Plans should cover the nature and level of support that will be provided during and after a pandemic. All four governments should develop a programme of peer support visits that can, from the outset of a pandemic, be targeted towards areas of acute hospitals under considerable strain. The purpose of the visits should be to support front-line staff, collect insights on the pressures that healthcare workers are facing and understand what further support they might need. See also: UK Covid-19 Inquiry Module 1: The resilience and preparedness of the United Kingdom Covid-19 Inquiry: Module 2, 2A, 2B, 2C Report – Core decision-making and political governance
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Content ArticleHealthcare safety activists have looked to checklists to solve a myriad of problems, particularly with the current iteration of checklists that have been imported from aviation. Large-scale implementations with conflicting outcomes suggest that these tools are not as simple or effective as hoped. Scholars debating the efficacy of checklist implementation in healthcare have identified important reasons for varying results: that success requires complex, cultural and organisational change efforts, not just the checklist itself; that results may be confounded by a mix of the technical and socioadaptive elements, and that local contexts may either augment or undermine the implementation's outcomes. When ideas are translated from one industry to another, the assumptions underlying the original concepts may be lost or diluted. As checklists are increasingly imposed through a variety of professional and regulatory mandates in North America, Europe and elsewhere, perhaps it is time to review the fundamental principles of checklist use, including why they might work and how we can implement them better.
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Content Article
NHS England: Treatment abroad checklist
Patient Safety Learning posted an article in Care settings
All types of medical treatment involve some element of risk. It's important to get as much information as possible about your treatment options so that you can make informed choices. Read the guidance provided by the NHS about going abroad for medical treatment and go through the checklist before making a decision. Make sure your decision is based on the quality of the medical care you would like to receive and not on how appealing the destination seems for a holiday. -
Content ArticleIn this blog Professor Henrietta Hughes, Patient Safety Commissioner for England, considers the publication of the new report ABHI Patient Safety System Foundations: A Call for Action, which sets out a blueprint for how industry can contribute to this transformation. She reflects on this report and the importance of recognising that patient safety is not simply a clinical issue, but is a system issue.
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Content ArticleIn this short discussion Professor Henrietta Hughes, Patient Safety Commissioner for England, speaks to ABHI Patient Safety Group Chair Greg Quinn and Vice Chair Steffanie Russell, following the publication of ABHI’s new report, Patient Safety System Foundations: A Call for Action. The conversation explores the role of system foundations in strengthening patient safety across healthcare.
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Content ArticleIn this short discussion, Greg Quinn, Chair of ABHI’s Patient Safety Group, and Helen Hughes, Chief Executive of Patient Safety Learning, introduce ABHI Patient Safety System Foundations: A Call for Action. Together, they discuss the report’s key themes, the persistence of avoidable harm, the need for system learning and shared accountability, and the vital role of HealthTech as a trusted partner in improving safety for patients and healthcare workers.
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Content Article
ABHI Patient Safety System Foundations: A Call for Action is a comprehensive report outlining how the HealthTech industry can work with partners across the system to reduce avoidable harm and strengthen safety for patients and healthcare workers. Developed with Patient Safety Learning, the report highlights the persistence of avoidable harm, the pressures facing the health system, and the far-reaching opportunities created by the NHS 10 Year Health Plan. It sets out ambitions for patients, healthcare providers, Integrated Care Boards, system leaders, regulators and industry. A central theme is the role of HealthTech as a trusted partner, with case studies demonstrating how technologies already in use are reducing infections, improving surgical pathways, supporting antimicrobial stewardship and lowering mortality in critical care. These examples show how well-implemented innovation can save lives, improve outcomes and release system capacity. The report also outlines specific actions for industry, from strengthening post-market surveillance to advancing equity and sustainability in product design and implementation. These recommendations underscore the importance of partnership, transparency and shared learning.- Posted
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Content Article
NHS England annual report and accounts 2024 to 2025
Mark Hughes posted an article in NHS England
This annual report contains information on NHS England’s work in 2024/25. It highlights their achievements, challenges and how the organisation has performed against its priorities. It also incudes financial statements for 2024/2025. -
News Article
US shutdown enters fourth week
Patient Safety Learning posted a news article in News
As the federal government shutdown enters its fourth week, pressure is mounting on the nation’s healthcare infrastructure. Paychecks have been halted for more than 1 million federal employees, critical agencies such as CMS are scrambling to maintain operations, and national disease surveillance efforts are beginning to fracture — just as the U.S. heads into the respiratory virus season. Funding delays are now directly affecting large swaths of the healthcare workforce and related support systems. More than 1 million civilian federal employees and military personnel — including those at HHS and the Department of Veterans Affairs — have begun missing their paychecks. The White House has suggested it may not provide back pay for furloughed federal workers, but the Internal Revenue Service has said it will be guaranteed, according to Axios. To fund the move, the agency is drawing on user fees collected from researchers accessing CMS data, with plans to reimburse the account once appropriations resume. The decision comes amid mounting pressure to stabilise key healthcare functions as disruptions and delays in telehealth reimbursement and hospital-at-home programs continue to ripple across the system. Read full story Source: Becker's Hospital Review, 27 October 2025 -
Content ArticleThe NHS is set to deliver faster care for millions of patients thanks to the most radical reset of the NHS in a generation. 2.5 million fewer patients will be waiting more than 18 weeks to receive planned care. 190,000 more cancer patients will begin potentially lifesaving treatment within 2 months of their referral over next 3 years. Patients to see faster access to diagnostic tests and GP appointments. The 3-year roadmap sets out the NHS plan to get back to delivering against its constitutional standards on elective care, which will see 2.5 million fewer patients waiting more than 18 weeks for treatment by March 2029. It will ensure 85% of people with a cancer diagnosis receive their first treatment within 2 months of a referral – up from 70% today. NHS analysis suggests just over 300,000 cancer patients will get their first treatment within 62 days of receiving a referral in 2028/29, up from 226,939 last year (2024/25). While 96% of patients will begin treatment within one more of a cancer diagnosis by 2028/29. Meeting these ambitious targets will be achieved by radically transforming how services are delivered – shifting more care out of hospital, freeing up capacity to drive down waiting times – and major improvements in health service productivity. As part of the biggest shake up of the NHS financial regime in more than a decade, hospitals will be financially incentivised to ensure more patients are treated out of hospital, instead receiving the care they need from local neighbourhood teams and in community diagnostic centres. This will start with immediate action to improve GP access and tackle unwarranted variation between practices – consulting on a new priority to deliver same day appointments, whether face to face, online or by phone, for all clinically urgent patients. The Framework also sets an ambitious target for 80% of community health service activity within 18 weeks – tackling long waiting times for community services, which have seen a surge in the number of adults and children waiting for more than 2 years for care. This will be supported by shifting more resources into community services for people with highest needs – such as frailer older people – reducing unnecessary hospital admissions and helping them manage their health at home. In line with the ambitions of the 10 Year Plan, the framework sets targets to make sure 95% of appointments after triage are available via the App and ensure all providers are leveraging the full potential of the Federated Data Platform by the end of 2028/29. Patients will no longer be asked to waste their time at follow-up appointments that aren’t necessary – freeing up clinicians to see the patients that need to see them most. Areas of the country that fail to progress on unnecessary follow ups will be performance managed. More patients will get appropriate care as part of the ‘Advice and Guidance’ scheme which allows GPs to get specialist clinical advice from leading experts at the touch of a button – rather than sending the patient for a hospital appointment which sometimes isn’t needed. Radiology departments will no longer be scanning people unnecessarily thanks to the rollout of i-Refer – an online software linked to real time up to date clinical guidance to ensure only those who need a scan are offered one.
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Content ArticleThe Government's new plan sets out how the NHS will reform elective care services and meet the 18 week referral to treatment standard by March 2029. Under this plan elective care will be increasingly personalised and digital, with a focus on improving experience and convenience, and empowering people with choice and control over when and where they will be treated. To meet the 18-week standard and reform elective care by March 2029, the plan focuses on: Empowering patients by giving them more choice and control, and by establishing the standards they can expect to make their experience of planned NHS care as smooth, supportive and convenient as possible. Reforming delivery by working more productively, consistently – and in many cases differently – to deliver more elective care. Delivering care in the right place to make sure patients receive their care from skilled healthcare professionals in the right setting. Aligning funding, performance oversight and delivery standards, with clear responsibilities and incentives for reform, robust and regular oversight of performance, and clear expectations for how elective care will be delivered at a local level.
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Content ArticleThis opinion paper addresses the role of nurses and the relevance of models and theories, both nursing and infection prevention and control (IPC), to visitor restrictions that were widely enforced in many countries during the COVID-19 pandemic, with a focus on person-centredness.
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Content ArticleHundreds of millions of people are denied health care every year by their private insurers. As a result, people stay sick or injured, and sometimes die. People are stuck with bills they can’t pay, take money from rent and food, and go bankrupt. Care Over Cost helps everyday people fight to get the care they deserve. Has a private insurer denied you care? Share your story with Care Over Cost and read other cases.
