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Virtual wards, also known as hospital at home, are increasingly being used across the NHS to support people who would otherwise need hospital care to receive treatment and monitoring at home. A new NIHR-funded study led by University of Manchester researchers explored how safe care is delivered in virtual wards, highlighting the often unseen work carried out by patients and carers as they undertake key elements of risk-work previously held by clinicians. The findings show that virtual wards can provide a safe alternative to hospital care for some patients, allowing people to recover at home while still receiving clinical oversight. However, patients and carers often take on more practical and emotional responsibility than may be recognised as they assume duties that would normally be carried out by clinicians in hospital settings. This includes monitoring symptoms, managing equipment and responding to signs of deterioration, especially overnight or outside normal working hours. The researchers suggest that hospital at home services that combine technology with in‑person home visits could help make care safer, more flexible, and accessible for a wider range of patients. Recognising and supporting the work undertaken by patients and carers is essential to ensure virtual wards are safely delivered. As virtual wards expand as a key component of NHS policy to shift acute care from hospital to community settings, practice must ensure there is space for relational and training support for clinicians, patients, and carers so that remote acute care can be safely implemented across health systems.

This Health Services Safety Investigation Body (HSSIB) report is the second in a series considering the self-administration of insulin by people with diabetes mellitus (diabetes) in community settings. Many people with diabetes manage and administer their own insulin, either by injection or using a combined monitor/pump device (a hybrid closed loop system). However, a disability or impairment may affect their ability to safely manage their own insulin if they are not supported. This can lead to short-term and long-term health problems, which can be life threatening. HSSIB identified incidents where a person with diabetes or their family/carer had administered insulin incorrectly (the patient safety issue of focus). In these incidents, a disability – such as a visual or memory problem – had influenced how someone had administered insulin. The investigation explored the following areas in relation to the patient safety issue: supporting the development of people’s competency – that is, their skills, experience, knowledge and ability – to manage insulin recognising and responding when people’s circumstances change, such as deterioration in a disability assessment of people’s mental capacity to make decisions in relation to insulin. Findings People with diabetes (who require insulin) are at risk of harm through the administration of insulin when pre-existing or new disabilities/impairments have not been recognised or adjusted for. People are not always empowered to become competent to manage their insulin, with assumptions made that a person is not competent to do so because of a disability/impairment. Supporting people to safely self-manage their health, including insulin, requires integrated working across community services. Where this is limited, such as due to resource challenges or limited collaboration, people are put at risk. Efforts to empower and enable people to self-manage insulin are affected by the competing demands on, and the capacity and accessibility of the community services that provide this type of support. Designated and protected resource aimed at supporting the development of insulin self-management skills have shown benefits for patient experience and have reduced demand on community services. There is no national competency framework for the management of insulin by patients and families that supports community services to identify and make reasonable adjustments for a disability/impairment. Administration of insulin by staff in care homes (delegated administration) may reduce demand on community teams but is limited by barriers to implementation, including high turnover of care home staff. Some people with type 2 diabetes may be prescribed insulin without first optimising other diabetes treatments and/or exploring preferences. This means a person may be exposed to the risks of insulin unnecessarily. There are people with diabetes (who require insulin) whose circumstances mean they are not monitored for changes in a disability/impairment, including via long-term condition reviews in general practice. People may not engage with healthcare services to enable the regular monitoring of their condition. Engagement is affected by the ability of services to meet patient needs but may also represent other situations that require a response, such as in relation to patient safeguarding. Electronic systems in general practice may not alert users when people have not requested repeat prescriptions of insulin, removing a potential opportunity to identify patients who need support. Diabetes technology, such as insulin pen devices, are not always designed in a way that supports people to administer insulin when they have a disability/impairment, such as visual impairment or problems with dexterity. There are concerns about the future competence of the healthcare workforce to support the increasing numbers of people with hybrid closed loop systems. Healthcare workers may not identify when a patient’s mental capacity to make decisions in relation to their insulin may be compromised, meaning a more in-depth assessment in line with the Mental Capacity Act (2005) may not occur. Limited education and practical support for application of the Mental Capacity Act (2005) by healthcare staff means its principles are sometimes misunderstood. Patients with diabetes (who require insulin) and who experience fluctuations in their mental capacity, are at risk of harm when services do not proactively plan for a time when the patient may lose the ability to manage their insulin safely. HSSIB makes the following safety recommendations HSSIB recommends that NHS England/Department of Health and Social Care provides guidance to integrated care boards and community providers setting out expectations for service models that empower and support people to manage and administer insulin in community settings. This is to support recognition of models that have safely, effectively and equitably engaged patients, their families and carers, including through the use of modern diabetes technology for self-management. HSSIB recommends that NHS England/Department of Health and Social Care develops a tool for use in community settings to support the assessment of competency of patients, their families and carers to manage and administer insulin and care for people with diabetes. This should include recognition of a person’s circumstances, the impact of disabilities and impairments, and potential adjustments to support administration where safe to do so. This is to support consistency in how competency is assessed for the safe management of insulin within the context of modern diabetes care. HSSIB makes the following safety observation National bodies can improve patient safety by providing clarity on expectations around 1) how staff recognise that a patient’s mental capacity may be compromised in relation to decisions about their self-management of insulin, and 2) the undertaking of a mental capacity assessment by the most appropriate person. This should include clarification on the practical application of the Mental Capacity Act (2005) to situations where a patient’s capacity may fluctuate and where sharing confidential information to support patient safety may be appropriate. HSSIB suggests safety learning for integrated care boards HSSIB investigations include safety learning for integrated care boards where this may help organisations think about how to respond to a patient safety issue that relates to integrated care across a geographical footprint. Informed by the findings in this report, the investigation proposes the following safety learning. HSSIB suggests that integrated care boards develop data-driven approaches to effectively identify the diversity of their populations’ characteristics and social circumstances, and use this data to support community providers to design services that empower and enable people to be involved in a patient’s care, including through supporting self-management of medications and conditions. HSSIB suggests that integrated care boards, through future planning for neighbourhood health services, include consideration of how patients who may be at greater risk of harm from insulin administration due to their specific circumstances – for example co-existing disabilities, social isolation or receiving home-delivered medications – are proactively monitored to identify changes in their circumstances. This may include using technology such as remote monitoring. Local-level learning HSSIB investigations include local-level learning where this may help providers/organisations respond to a patient safety issue at the local level. Informed by the findings in this report, the investigation shares the following local-level learning. How does your organisation create the conditions for staff to empower and enable patients, their families and carers – through a person-centred approach – to self-manage insulin where appropriate? How does your organisation proactively identify the varying needs of people with diabetes in its local population, and ensure these are met to enable their management of insulin? How does your organisation promote patient-centred care and facilitate self-care models that empower and enable patients, such as those with diabetes? Does your organisation allocate specific resources to support patients, families and carers to develop competency to self-manage insulin, and ensure those resources are protected to empower and enable people? How does your organisation ensure that staff supporting the development of a person’s competency have the required knowledge and skills to provide that training and education in relation to diabetes and insulin? How does your organisation support staff to identify and code a person’s disabilities/impairments that may influence their competency to self-manage insulin, and ensure these are considered and adjusted for when deciding whether a person is competent? Does your organisation have systems and processes to identify where patients have not requested their repeat medication prescription, or the frequency of the requests have changed, which may indicate changes in their circumstances? How does your organisation ensure long-term condition reviews reliably take place for patients who may be at a higher risk of deterioration due to their circumstances, for example those with multiple long-term conditions? How does your organisation identify and code patients – who may be more vulnerable to harm from insulin due to their circumstances – for increased monitoring? This may include patients who have their medications delivered to their home, who do not have family nearby, or who are housebound. Does your organisation provide practical training and guidance to support staff to consider the mental capacity of patients to make decisions around their insulin when there are concerns capacity may be compromised? Does your organisation provide practical guidance to staff to help identify when it is lawful, ethical and appropriate to share confidential information about a patient to mitigate risks to their safety, including with family members? Does your organisation have accessible routes via which staff can seek urgent support when they are concerned a patient’s mental capacity to make decisions about their self-care may be compromised, particularly in high-risk situations? How does your organisation support staff to develop ‘crisis plans’ for patients who self-manage insulin to protect their safety at a later point when their capacity to make decisions in relation to their care may change?

Understanding a new medical condition can be overwhelming, and navigating the process of seeking diagnosis and specialist care can feel complex. That’s why Allergy UK have created the Allergy Self-Help Hub. It’s your first stop for understanding allergies, preparing for the journey ahead, and equipping yourself with the tools and knowledge to navigate the process. With these resources, you’ll be ready to make the most of your interactions with healthcare professionals and ensure you get the support and treatment you need.

Latest research from the King's Fund shows no improvement in people’s experiences of NHS admin. NHS admin plays a central role in shaping how people experience and perceive the NHS. Our findings point to a major opportunity for government and NHS leaders to act. Key findings Two thirds (66%) of patients and carers who used NHS services in the past 12 months experienced at least one administrative problem. There has been no improvement since the same polling was conducted the previous year. While the number of people experiencing admin issues has remained unchanged, what has shifted is wider public awareness: administrative failings are increasingly recognised as a frequent and persistent problem across the NHS. In 2025 less than half (43%) of the public said that the NHS is good at communicating with patients about things like appointments and test results, down from 52% in 2024. The percentage of the public who said the NHS was good at keeping people informed about what is happening with their care and treatment has fallen from 42% in 2024 to 32% in 2025. 33% of people who had used NHS services in the previous 12 months said they had not been kept updated about how long they would have to wait for care or treatment. Almost 1 in 4 people who had used NHS services in the previous 12 months (23%) reported being invited to an appointment after the date of the appointment – a 3 percentage point increase since 2024. 3 in 5 people who had experienced admin issues (60%) said it made them think that NHS money is being wasted. People living with a long-term health condition are more likely to say the NHS is poor at keeping people informed about what is happening with their care and treatment (45%), compared with 36% of people who do not have a long-term condition. 4 in 5 patients and carers (81%) who report they are struggling financially have experienced an issue with NHS admin, compared with 63% of those who are comfortable financially. Related reading on the hub: The challenges of navigating the healthcare system

Medicine is still debating whether artificial intelligence will match or exceed human diagnostic skill. But the most consequential change is already happening elsewhere. It is unfolding quietly in the relationships patients are forming with AI systems, and in the narratives they bring with them before a clinician ever enters the room. If general practice only looks for it inside the consultation, it will be reacting to consequences rather than causes. Adam Phillips is a UK medical student and former IBM technology consultant, and Simon Rudland, visiting professor of integrated digital health at the University of Suffolk, describe these dynamics as post-Turing clinical relationships (PTCRs). In these relationships, patients develop sustained, functionally supportive interactions with AI tools that influence how they interpret symptoms, regulate anxiety, decide when to seek care, and engage with clinicians. The changes are uneven, but they are already reshaping consultations and continuity in ways general practice is only beginning to notice.

Advice and Guidance (A&G) has been used in the NHS for years. It helps GPs get advice from specialists on a patient’s condition to decide the best course of treatment. The Department of Health and Social Care sets out the facts following media reports with a letter from the Health and Social Care Secretary Wes Streeting, published in the Daily Telegraph on 31 March.

An article about the many mistakes that were made by healthcare staff after a patient's adverse reaction to an antidepressant. This article emphasises that mistakes in healthcare are not only still prevalent, but some can only be picked up through the patient's experience. Most of the healthcare professionals in the story never realised they made a mistake. These mistakes cultivated a loss of trust between patient and healthcare professional, among other negative consequences. The story highlights the importance of the patient perspective in patient safety.

The 'Please, Write to Me' guidance from the Academy of Medical Royal Colleges provides information and advice to encourage and support healthcare professionals to communicate directly with patients in writing.  This guidance was first published in 2018. As a result, many clinicians began writing directly to patients in plain English following outpatient clinic consultations. This has since been recommended as best practice by professional and NHS bodies, the General Medial Council, and the UK Government. This update extends the guidance to include writing a section of discharge summaries directly to patients following a hospital admission. This guidance and governance safeguards should also be applied when developing and using AI systems to create clinical documents for use in training and practice.

The 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.

This leaflet produced by the Nursing and Midwifery Council (NMC) can help you decide what you could do if you think a midwife, nurse or nursing associate may have done something wrong. This leaflet explains how we can help if someone has concerns about the care provided by a midwife, nurse or nursing associate during pregnancy, birth or the postnatal period. It covers: what the NMC does and when concerns should be raised with us what happens when someone contacts the NMC where people can go for other types of support, including employers and other organisations that may be better placed to help.

The 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