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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

As one of the three shifts set out in the 10 Year Health Plan, technology and the digitisation of health and care is expected to change the way people access and interact with services, reduce administrative tasks to free up staff time, and even prevent ill health occurring in the first place. While the technology landscape is evolving rapidly, the NHS itself is also undergoing significant structural change, including the planned abolition of NHS England and substantial cuts across integrated care boards. These changes have direct implications for the entire workforce, and the patients and communities they support. This free King's Fund online event, will explore what health and care leaders need to truly shift from analogue to digital; recognising that transformation, innovation and partnership working demands good leadership, the right infrastructure and capacity and capability development. The event will discuss: the current state of digital leadership across systems and organisations with different levels of digital maturity examples where structural changes and budget cuts are having an impact on digital priorities outlined in the 10 Year Health Plan emerging approaches to deliver digital priorities that better care for patients. Register

On the 14 May 2026 the UK Government introduced the Health Bill in the House of Commons, also known as the NHS Modernisation Bill. This new legislation is intended to introduce two significant changes, joining up health information and abolishing NHS England. This article pulls together a number of different reflections shared on this bill as it proceeds through Parliament. The Health Bill 2026-27 is a new piece of Government legislation which aims to: Improve patient safety and experience through a new single patient record, enabling joined-up, proactive care and empowering patients. Put power and resources in the hands of frontline NHS organisations by abolishing NHS England and stripping back national bureaucracy. Clarify the role of local health bodies, giving them real flexibility to design and deliver health services to best meet the needs of their local populations. Department of Health and Social Care The UK Government has published a collection of resources about the Health Bill, including fact sheets on the following topics: Single Patient Record Role and functions of the restructured Department of Health and Social Care Data and digital functions Oversight of the health system Integrated Care Boards as strategic commissioners Providers Patient safety Patient voice Patient Safety Learning Following the announcement of the NHS Modernisation Bill in the King’s Speech 2026, Patient Safey Learning published an article highlighting six key takeaways from this speech from a patient safety perspective. This includes reflections on specific provisions in the Bill including: Transferring the Health Services Safety Investigations Body functions to the Care Quality Commission. Creating a new single patient record. Transferring the functions of Healthwatch England to the Department of Health and Social Care and creating a new Patient Experience Directorate in the Department of Health and Social Care. Abolish NHS England and making several changes to the role of Integated Care Boards. The King’s Fund The health and care charity and think tank The King’s Fund have created on a new area on their website where they are sharing all their latest analysis, commentary and responses on the Health Bill as this legislation developments. This includes an article by their Chief Executive Sarah Woolnough setting out five tests for the NHS Modernisation Bill. Nuffield Health In this article, Becks Fisher, Director of Research and Policy at the Nuffield Trust, discusses key issues raised by the NHS Modernisation Bill. He considers this in the context of the departure of Wes Streeting MP as Secretary of State for Health and Social Care, and his replacement with James Murray MP. Health Service Journal In this episode of the Health Service Journal Health Check Podcast, Annabelle Collins and Dave West are joined by Hugh Alderwick, Health Foundation director of policy and research, to help unpick the 200-page legislation and what it will mean for the service. Carnall Farrar (CF) In a helpful infographic, CF’s snapshot of the NHS Modernisation Bill focuses on the provisions most relevant to NHS leaders and executives: what is changing, when, and what it may mean in practice.

The King’s Speech 2026 sets out the programme of legislation that the UK Government intends to pursue in its next parliamentary session. This blog highlights six key takeaways from this speech from a patient safety perspective. On Wednesday 13 May 2026, Kings Charles III delivered his annual speech in the Lords Chamber at the State Opening of Parliament.[1] Written by the Government and delivered by the Monarch, the speech presents opportunity at the start of a new parliamentary session for a government to set out its plans for the year ahead. This year’s speech includes two pieces of proposed legislation that have, potentially, significant implications for patient safety: NHS Modernisation Bill Public Office (Accountability) Bill In this blog, we highlight six takeaways from these proposed bills from a patient safety perspective. 1. Future of the Health Services Safety Investigations Body The NHS Modernisation Bill includes several changes to the patient safety landscape in England. These involve the implementation of several key recommendations put forward in Dr Penny Dash’s Review of patient safety across the health and care landscape last year.[2] This includes the recommendation to transfer the Health Services Safety Investigations Body (HSSIB) functions to the Care Quality Commission (CQC). In our response to the Dash Review, we stated our belief that HSSIB has an important independent role in the health system which should be retained.[3] There are understandable concerns about the potential for its independence to be compromised by its functions being transferred to the CQC.[4] [5] More broadly, we know that many staff working in healthcare do not feel confident raising concerns. As NHS Staff Survey results continue to illustrate, nearly two-fifths of staff say they do not feel safe to speak up about concerns.[6] Recognising the importance of staff feeling able to speak freely in investigations, HSSIB currently conducts these using a ‘safe space’ approach. This prohibits, on a legal basis, the unauthorised disclosure of protected material. Even if this legal assurance is maintained under these proposed changes, there still may be concerns that moving HSSIB into the CQC could potentially undermine staff confidence that confidentiality will be maintained. If confidence in the independence and confidentiality of HSSIB’s investigations is undermined, whether in reality or perception, this could compromise understanding of what is really happening on the ground. HSSIB’s ability to do this is an essential prerequisite to understand what the risks to patient safety are and the action needed to address these. We await further detail in the NHS Modernisation Bill on how these challenges will be addressed. 2. Embedding patient voice in national decision making Other notable recommendations from Dr Penny Dash’s review expected to feature in the NHS Modernisation Bill include: Transferring the functions of Healthwatch England to the Department of Health and Social Care. Developing a new Patient Experience Directorate in the Department. In our response to the Dash Review, we welcomed the proposal to create a new National Director of Patient Experience, alongside a Patient Experience Directorate. A new central body offers potential benefits for pooling expertise and resources. However, questions remain as to whether these changes could risk making the routes through which patient experience and concerns influence decision making less visible and more diffuse.[7] [8] [9] [10] It is vital that these changes improve the health systems capacity to listen and respond to patient experiences. We believe that an important element of this will be ensuring this new Patient Experience Directorate can benefit from regional and local experience and expertise. We would expect to see further detail setting this out in due course, considering how this will connect with local models for engaging with patients, families and carers. Specifically, we would also seek clarity on how this Directorate will work with local and national Patient Safety Partners, whose roles were not mentioned in the Dash Review. 3. Creating a new single patient record Another key strand of the NHS Modernisation Bill will be plans to create a new Single Patient Record. This is intended to “enable people to see their own health records securely on the NHS App, empowering them to make informed decisions about their own health”.[11] In our response to the 10 Year Health Plan for England, we stated our support for this initiative.[12] It is broadly acknowledged that if implemented effectively, this could make a real difference in improving joined-up communication in the NHS.[13] Patients not only need easy access to their records, but simple mechanisms to flag concerns and address any inaccuracies in a timely manner. Mistakes in records can create significant patient safety risks, and as illustrated by patient experiences shared with us on our patient safety platform the hub, amending these is often not a simple process.[14] 4. Introducing the Hillsborough Law The proposed Public Office (Accountability) Bill would put in place a new professional and legal Duty of Candour—meaning public officials must act with honesty and integrity at all times. This was previously announced in September 2025 and the Bill itself has already been tabled in Parliament.[15] We welcome this legislation. Patient Safety Learning believes it should be a requirement to be honest and transparent with patients and their families when something goes wrong, and this should be fundamental for all staff. The proposals in this new legislation have greater scope than the existing statutory Duty of Candour in the NHS, with a focus on systemic institutional behaviour. It is also notable that these provisions of the Bill will apply to the whole of the UK, not just England and Wales. 5. Abolition of NHS England The NHS Modernisation Bill will legislate to integrate NHS England’s functions into the Department of Health and Social Care, as first announced last year.[16] While we are still waiting further detail of what this will look like in practice, the existing National Patient Safety Team at NHS England is likely to be impacted by these changes. This Team is currently responsible for owning various patient safety programmes and policies and issuing safety warnings and recommendations. As stated in our response to the 10 Year Health Plan for England, an area of concern for us remains the lack of significant capacity to intervene if necessary for the purposes of improvement at a national level. Alongside this, there is also currently no national body able to commission or develop solutions that all organisations can use and adapt to improve patient safety. If healthcare providers identify a systemic issue that needs to be addressed because it affects other organisations, there is no national organisation that has the role or capacity to act on this. Instead, providers are left to find local solutions to system-wide concerns without a vehicle for widespread dissemination and evaluation. We believe this gap places a serious limitation on the healthcare system’s ability to reduce avoidable harm. It does little to address the inconsistencies in care across the country, with multiple different responses and workarounds to system-wide problems with varying levels of success. It is also a significant missed opportunity if we fail to take learning gained from provider organisations and apply this nationally for improvement in a meaningful way. This is an issue we think should be considered and addressed in the future merger of NHS England and the Department of Health and Social Care. 6. Changes to Integrated Care Boards Finally, the NHS Modernisation Bill will also include several changes for Integrated Care Boards (ICBs), including: Refine the membership of ICBs. Placing new requirements for mayoral nominees to be on ICBs. Confirming their role as strategic commissioners, by transferring responsibilities for all but the most specialised commissioning functions to ICBs. In a joint blog with the Advancing Quality Alliance (Aqua) earlier this year, we noted that there is huge opportunity for ICBs to drive a systemic approach to patient safety through their strategic commissioning responsibilities.[17] [18] [19] However, there is currently significant variation in ICBs involvement in safety management activities.[13] With the right support ICBs have the potential to develop an integrated and coordinated approach to safety, reflecting patient care pathways across systems and ensuring consistency and collaboration. We would hope to see this included in these changes considered in the provisions of the NHS Modernisation Bill, and in the forthcoming new NHS Quality Strategy. References Prime Minister’s Office. 10 Downing Street. Oral statement to Parliament: The King’s Speech 2026. 13 May 2026. Department of Health and Social Care. Review of patient safety across the health and care landscape. 7 July 2025. Patient Safety Learning. Review of patient safety across the health and care landscape: Patient Safety Learning‘s response. 15 July 2025. Macrae C. Failing to learn? The NHS is losing its capacity for system-wide safety investigation. Journal of the Royal Society of Medicine, 2025; 118(10). Health Service Journal. Merging watchdog into CQC will ‘destroy’ independence. 26 February 2026. Patient Safety Learning. Patient Safety Learning’s response to the NHS Staff Survey Results 2025. 13 March 2026. Martin G, O’Hara J. Hope over experience? Patient and staff voice in the NHS after the Dash review. 1 2025;390:r1514. Cox C. Is the patient voice fading? Reflections on patient safety in a changing NHS. Patient Safety Learning. 28 January 2026. Morris L, et al. The Kings Fund. The future of patient voice: learning from the Healthwatch model. 18 March 2026. Patient Safety Learning. Patient voice, safety and the NHS 10 Year Plan: Reflections from the Patient Safety Forum 2026. 23 March 2026. Prime Minister’s Office. 10 Downing Street. King’s Speech 2026: background briefing notes. 13 May 2026. Patient Safety Learning. 10 Year Health Plan: Patient Safety Learning’s response. 14 August 2025. The Kings Fund. The King’s Fund responds to the King’s Speech and the introduction of the NHS Modernisation Bill. 13 May 2026. Anonymous. The digitalising of patient records – why patients MUST be involved. Patient Safety Learning. 16 April 2024. House of Commons. Public Office (Accountability Bill), Session 2024-26. Last updated 5 May 2026. Department of Health and Social Care. World’s largest quango scrapped under reforms to put patients first. 13 March 2025. Patient Safety Learning and Aqua. Patient safety and the new NHS Quality Strategy. 25 February 2026. Aqua. What Should Safety Look Like at a System Level. 6 April 2023. Patient Safety Learning. The elephant in the room: Patient safety and integrated carer systems. 11 July 2023. Health Services Safety Investigations Body. Safety management: accountability across organisational boundaries. 13 February 2025.

More than a year on after its publication, the focus has shifted from ambition to action. What does it really look like to turn the plan into reality? What challenges have emerged, where have leaders found ways through and what does this early progress tell us about what comes next? At the centre of the plan are three shifts – moving care from hospitals to local communities, preventing illness not just treating it, and realising the potential of digital technology. But what do the shifts actually mean in practice for those working locally and a year on does it feel any different for staff, patients and communities? Join the King's Fund to take stock of progress a year on, explore what still needs to happen and look ahead to what will be possible if the ambitions of the 10 Year Health Plan are brought to life. Sessions will explore: what progress has been made a year on changes in the policy landscape over the past year what the shifts mean for the experience on the ground for staff, people and communities the tension leaders face between balancing delivering the plan and other priorities what the future of ‘patient power’ can and should look like how leaders can unlock their agency to drive change how local systems have been delivering the three shifts and how to take this further what is possible if the plan is fully realised. Register

Nurses are at the forefront of health and social care delivery. Often they are also leading, championing and driving change for patient safety. In this edition of our ‘Top picks’ series we celebrate some of the amazing work nurses are doing to prevent avoidable harm and improve patient and staff experience. The examples below include blogs, interviews and practical improvement projects. They have been shared with us by members of the hub, a global community of people passionate about patient safety. You can sign up to the hub here, it’s free and easy to do.  Safety tools, approaches and insights Implementing the aSSKINg pressure ulcer care bundle – a blog by Susan Martins Nurse-led use of technology to enable better care - Homerton University Hospital Action Card App Yellow kits - an innovation to reduce the risk of falls in Accident and Emergency departments Friends of African Nursing: Training perioperative nurses across Africa Measuring standards of care, not negative outcomes Nobody left behind: Improving the health of people with learning disabilities and reducing inequalities across primary care Tackling antibiotic underdosing: Interview with Ruth Dando, Head of Nursing for Theatres, Critical Care and Anaesthetics at BHRUHT Insights from a reducing falls project at the University Hospital Southampton How a catheter removal project improved care for patients while saving money and carbon emissions Safety culture How a simple newsletter can improve culture and communication within teams It’s time to look beyond perceived barriers to Family Integrated Care in the NICU and create a culture for change Safety Incident Supporting Our Staff (SISOS) Safety Chats Interviews with nurses In our series of Patient Safety Spotlight interviews, we talk to different people about their role and what motivates them to make health and social care safer. Martin Hogan, Lead Professional Nurse Advocate at Central London Community Healthcare NHS Trust Kathy Nabbie, Theatre Scrub Nurse Practitioner and Non-medical Surgical First Assistant Angela Hayes and Caroline Morris, Palliative Care Nurse Specialists at The Christie NHS Foundation Trust In an episode of our Speaking up for patient safety interview series, we spoke to Rebecca Wight, a nurse consultant practitioner. Rebecca talks about what happened to her when she tried to raise patient safety concerns about a colleague. Speaking up for patient safety: Rebecca Wight in conversation with Peter Duffy and Helen Hughes Could you share for safety? Are you a nurse with a passion for patient safety? Do you have insights, projects or practical tools and resources that could be shared for wider benefit? Perhaps you’d like to feature in one of our Spotlight interviews? You can get in touch with our hub editorial team by emailing us at [email protected]

Clinical huddles, safety briefings and board rounds are now core tools for managing safety, flow and workforce pressures in real time. Done effectively they: give teams a shared picture of risk surface concerns from all staff improve visible leadership, communication and teamwork proactively improve patient safety in real time help prioritise work and escalation turn “soft intelligence” into concrete actions. Done badly, they have the potential to become tick-box rituals that waste time, shut down voices and do not result in improvement or change. This practical masterclass will focus on how to design and lead brief, focused and effective clinical huddles and safety briefings in busy NHS environments. It will explore different types of briefings (start-of-shift, safety huddles, flow huddles, theatre briefs, board rounds and debriefs), and how to make sure they genuinely improve safety, flow and team culture rather than becoming “just another meeting”. The event will also support you to redesign and improve your huddles and briefings for maximum impact. Through expert input, practical examples and focused exercises you will build the skills and confidence to lead briefings that: run to time are well attended involving the whole multidisciplinary team surface concerns from all staff improve patient safety in real time result in clear, trackable actions. Register hub members receive a 20% discount. Email [email protected] for discount code.

In this podcast interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care. In this episode, Helen and Peter speak to Rebecca Wight, a nurse consultant practitioner. Rebecca talks about her time at the The Christie, a cancer treatment centre in Manchester, and what happened to her when she tried to raise patient safety concerns about a colleague. Despite escalating these concerns to management and clinical leadership, Rebecca reported being ignored, having her concerns dismissed as a personal attack, and facing a "brick wall" from leadership. Rebecca reflects on the toll the process took on her and her family, her experience of going through an employment tribunal and why there needs to be more support for people who raise concerns within their organisation. Subscribe to our YouTube podcast to keep up to date with the latest episodes. Transcript of the interview Read a blog from Peter and Helen about the interview series