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Patient’s sharing details about their life with their medical team can help build better relationships, according to healthcare workers who have used the practice in Switzerland. Patients are asked to provide a short biography which is shared with nurses, surgeons, anaesthetists and other people involved in their treatment. The medics also offer information about themselves and claim the project has helped them create better connections and improved interactions. Professor Pietro Majno-Hurst and his colleagues described their experience of the scheme in an article on the BMJ website. It said: “After more than one hundred requests so far, refusal to provide a biography has been rare (<5%). Some patients have remarked on a positive difference in their interactions with staff who had read the biography versus those who had not. It is important to set aside time in the care pathway to read the patient’s text. “We are our biographies. Seeing ourselves and each other as unique human beings in the face of challenges should be an important part of clinical practice, but it is missing when the individuality of patients and health professionals is pushed aside. “Perhaps it is not by chance that the idea of allowing patients and doctors to introduce themselves this way arose in a surgical ward, where technical competence and formality of the setting may feel detached and impersonal. Sharing biographies has shown us an accessible and effective tool for establishing better connection and care.”

Inpatient mental health services in the UK are under intense scrutiny and increasing pressure. Staff shortages, patient safety concerns, and outdated environments are just some of the issues drawing media and political attention. There’s widespread agreement that improvements are needed, but the question is: where do we begin? This HSJ article highlights five shifts that are needed to help inpatient mental health services better support the people they serve.

A new report from National Voices, undertaken in partnership with Future Health and commissioned by AbbVie, reveals the decline in patient experience for those with long-term conditions in recent years. It calls for urgent Government action to address it as part of the forthcoming Ten Year Health Plan, with a focus on improving the way we measure, understand and act on people’s experiences.

This King's Fund report focuses on the clinical co-ordination of care for people with multiple long-term conditions as part of a wider holistic approach. It outlines a set of principles on clinical co-ordination for commissioners and healthcare professionals that should underline a new approach to care for people with multiple long-term conditions. Key messages Clinical care should, by default, consider that people may be presenting with multiple long-term conditions. There are now more and more people living with multiple long-term conditions, and people’s health conditions rarely fall neatly into separate clinical categories. Current models of care based on isolated care plans and siloed service pathways lead to poorer experiences and outcomes for people and inefficiencies for service providers. Co-ordinating clinical care is vital for getting the right support for people with multiple long-term conditions. This requires changes in how clinicians work, and how commissioners support them. IT systems, information governance and physical infrastructure are all key enablers of clinical co-ordination. It is essential that clinicians understand why and how changes will benefit them and their patients, and that patients and carers are able to access the information they need for their own agency and control. Whatever configuration they work in, clinicians need to ensure that they have clearly defined roles and responsibilities, and should develop their understanding of each other’s roles to support more joined-up thinking. Training – including continuing education – is important to support this. Removing financial system constraints, such as changing incentives to align with effective care for people with multiple long-term conditions, is an essential part of future-proofing the system against poor-quality provision for the increasing numbers of people living with such conditions. Local service design needs to be co-produced based on deep population knowledge as well as drawing on clinician and patient perspectives; there is no one model for caring for people with multiple long-term conditions, but there should be shared principles such as good communication, holistic care and access to information. Prioritising the development of outcome-based metrics – in particular those metrics that consider the impact of care co-ordination across conditions – in partnership with patients will help to improve understanding of the approach to care that can best address the needs of people with multiple long-term conditions and enhance the overall quality of that care.

The overarching vision of the NIHR Yorkshire and Humber Patient Safety Research Collaboration (PSRC) is to co-produce innovative solutions to make care safer for patients and their families. Key to this is ensuring that these solutions reflect and meet the needs of our diverse communities. This can be achieved by working with and for patients, families, and health and social care staff, grounding our research in their daily realities and the evolving system within which care is delivered. This PPIE strategy offers the mechanisms by which we can deliver on this, recognising that respectful and trusting relationships are the cornerstones to making effective change.

This report from the Partnership for Change explores one of the most persistent challenges patients face: poor care co-ordination. It draws on insight from across the health charity sector to offer a clear and practical vision for improving how care is delivered and experienced in the NHS. The Partnership for Change is a collaboration of ten leading patient groups brought together and funded by Pfizer.  The report outlines a set of recommendations to help the NHS, and wider health systems, put patients at the centre of co-ordinated care. The report recommendations are to: Measure patient experience and act on the data. Make communication between healthcare, professionals and patients simpler, quicker, and more efficient. Proactively build a culture of collaboration. Take a holistic approach to care for long-term conditions. Related reading on the hub: How the Patients Association helpline can help you navigate your care Care co-ordination for people with long-term conditions: Patient Safety Learning’s response to HSSIB investigation #NavigatingHealth—Enabling every patient, every time, system-wide The challenges of navigating the healthcare system

In June 2023 the Secretary of State for Health and Social Care announced that HSSIB would undertake a series of investigations focused on mental health inpatient settings. This overarching report brings together and explores cross-cutting patient safety risks across five individual investigations. The aim of this report is to examine patient safety risks identified across the following HSSIB investigations: Creating conditions for learning from deaths and near misses in inpatient and community mental health services: Assessment of suicide risk and safety planning (12 September 2024) Creating conditions for the delivery of safe and therapeutic care to adults in mental health inpatient settings (24 October 2024) Mental health inpatient settings: out of area placements (21 November 2024) Mental health inpatient settings: Supporting safe care during transition from inpatient children and young people’s mental health services to adult mental health services (12 December 2024) Mental health inpatient settings: Creating conditions for learning from deaths in mental health inpatient services and when patients die within 30 days of discharge (30 January 2025) Findings Safety, investigation, and learning culture There remains a fear of blame in mental health settings when safety events happen. This contributes to a more defensive culture despite staff actively wanting to learn. Many recommendations to support learning for improvements in mental health care do not lead to implemented actions. Reasons for this include a lack of impact assessment resulting in unintended consequences, no clear recipient involved in the development of recommendations, and duplicated recommendations across organisations. System integration and accountability The integration of health and social care within an integrated care system currently relies on relationships, with an expectation and hope that they will work well. However, where this is not the case, a lack of clear accountability can result in poor outcomes for people with mental illness and severe mental illness. The delivery of care for people with mental illness and severe mental illness is challenging because health and social care services are not always integrated and their goals are not always aligned. Physical health of patients in mental health inpatient settings There are gaps in the provision of physical health care for people with severe mental illness, including inconsistent health checks, poor emergency responses, and misattribution of physical symptoms to mental illness. The misattribution of physical symptoms to patients’ mental health was observed and had the potential to contribute to worsened patient outcomes. National reports, strategies and research have made recommendations to improve the physical health of people with severe mental illness. However, there is evidence that recommendations are delayed in implementation and people continue to die prematurely. Integrated care boards lack the required data and the necessary analytical capability to assess disparities in access, experience and outcomes related to the physical health needs of people with severe mental illness. There is variation in how the physical health checks are carried out on mental health inpatient wards, with limitations in processes for following up on patients’ physical health needs. There is variation in the knowledge, skills and experience of staff who undertake physical health checks and in the environments in which these checks take place. Patients may not always be supported in terms of health education about their physical health risks and modifiable risk factors, for example smoking, dietary advice and physical activity. Caring for people in the community Integrated care boards cannot consistently draw reliable insights from data at national, system or local level, to optimise and improve services, patient care, and outcomes across mental health pathways of care. This results in variability in service provision which does not always meet the needs of individual patients or local populations. Inpatient ‘bed days’ are taken up by people who no longer need them, because people who are clinically fit for discharge are delayed in being transferred to their home or a suitable residence (appropriate placement). Reasons for delayed discharges include issues with housing support and establishing suitable accommodation. This means patients are not always in the right place of care. Barriers to discharge affect patient flow and may result in delays in admission for people with severe mental illness. This means they have to be cared for in a community setting while waiting for an inpatient bed. There is variation across the country in how drug and alcohol services are provided. The variation does not allow for fair and equitable treatment for all patients. Community services are vital to support people to stay as well as possible and to prevent hospital admissions. However, there is variation in community service provision across the country. Staffing and resourcing Staffing and resource constraints in inpatient and community mental health settings impact their ability to provide safe and therapeutic care. In inpatient settings, constraints contribute to mental health wards aiming to staff for ‘safety’ but not always for ‘therapy’. Challenges for staff include the emotionally demanding nature of their work; this can lead to staff burnout and sickness, and further strain on services. There are gaps in mental health workforce planning, particularly in community services where there is no evidence based workforce planning tool to support a standardised staffing establishment setting model. Digital support for safe and therapeutic care A lack of interoperability or integration between digital systems affects the provision of care across mental health, acute and community providers. Challenges in securing appropriate funding impacts on the ability of hospitals to integrate and update their digital services and infrastructure. Electronic patient record functionality is often not available or does not meet staff needs, and so it is not used. Examples include absent functions for food and fluid balance monitoring and risk assessment of venous thromboembolism (blood clots). Challenges in providing and maintaining patient-facing technology, for example televisions and payphones, impacts on the therapeutic environment and the ability of patients to maintain contact with families and loved ones. Where technology for monitoring patients had been introduced, implementation has required considerations to ensure it is used appropriately, is patient-centred, maintains therapeutic engagement, and supports patients to feel safe. Suicide risk and safety assessment ‘Doing’ tasks, like ‘ticking’ checklists, overshadow meaningful, empathetic ‘being’ interactions with patients. Open, compassionate conversations that build trust and therapeutic relationships, enabling patients to own their risk while feeling supported, can help mitigate this. Investigation processes can contribute to a fear of blame, and subsequently contribute to defensive practices such as checklists and a ‘tick box’ culture. This inhibits open and honest conversations and the ability to put the patient, as their authentic self, at the heart of them. Safety recommendations HSSIB recommends that the Department of Health and Social Care continues to work with the ‘recommendations but no action working group’ and other relevant organisations, to ensure that recommendations made by national organisations specific to mental health inpatient settings are reviewed. This work should consider the mechanisms that supported or hindered the implementation of actions from these recommendations. This may help the Department of Health and Social Care understand what has worked when implementing actions from recommendations and enable learning about why some recommendations have not achieved their intention. HSSIB recommends that the Secretary of State for Health and Social Care directs and oversees the identification and development of a patient safety responsibilities and accountabilities strategy related to health and social care integration. This is to support the management of patient safety risks and issues that span integrated care systems. Safety observation National bodies can improve patient safety in mental health inpatient settings in England by supporting provider investment in equipment, digital systems and physical environments to enable conditions within which staff are able to provide, and patients can receive, safe and therapeutic care.

The Patients Association and the Royal College of Physicians (RCP) have published a joint report setting out a bold new vision for reforming outpatient services in the NHS over the next decade. Outpatient care (planned specialist care delivered without an overnight hospital stay) is one of the most commonly used NHS services, with over 135 million appointments in 2023/24 alone. Yet for many patients, the experience is marked by long waits, fragmented communication, and a lack of coordination between services. Drawing on extensive engagement with patients, clinicians and NHS England, Prescription for outpatients: reimagining planned specialist care outlines five key ambitions to reshape the outpatient model: provide timely care by the right person, in the right setting, empower patients through personalised care and self-management, improve communication across professionals and with patients, use innovative models of care to avoid unnecessary appointments, harness data and technology to reduce inequalities and prioritise need. The report also proposes eight transformational shifts to how care is delivered, supported by five key enablers including digital infrastructure, workforce investment, and improved commissioning models. Collectively, these changes aim to ensure outpatient services are more efficient, equitable and centred around patients' needs.

High-quality written information for patients can improve their experience of what’s involved in a hospital visit by reducing uncertainty and anxiety. However, there may be unintended consequences of providing this information: for example patients may become concerned about things they had not previously considered. Although many hospitals recognise the need to provide information to patients who are children and their parents or carers, most locally developed leaflets have not been formally evaluated. This study involved the development of an information leaflet to give to children aimed at answering common questions they may have about going into hospital, and then evaluating the intended and unintended consequences of the distribution of the leaflet. A leaflet called “Coming to hospital: a guide to what goes on” was produced in partnership with Usborne Publishing, aimed at helping paediatric patients understand what to expect about admission to hospital and to help them feel calmer about it. It was based on an Usborne book “Look inside a Hospital” and was distributed to paediatric patients (aged 4–14) at Cambridge University Hospitals NHS Foundation Trust. A questionnaire was developed to assess patients’ views on the leaflet. The questionnaire used an emoji scale to determine what emotions the leaflet elicited, open-ended questions to gain more detailed responses, and a section for parents or carers to provide comments. There were 3,000 copies of the leaflet printed and distributed, and 72 children were involved in the evaluation. Parents and carers were positive about the leaflet, and particularly about the writing, illustrations and explanations. Many said they wished they had seen it before they attended hospital. Overall, the leaflet was positively received by children and parents, and was not reported to provoke anxiety or significant numbers of new questions. In response to suggestions, the word ‘patient’ was changed to personal pronouns throughout the leaflet and other helpful sections on subjects such as visiting times and parking were added. Wider availability of the leaflet to paediatric inpatient populations could make children feel calmer on admission to hospital. Further research on the effects of this leaflet in more diverse populations would be welcome, along with whether disease-specific leaflets would be beneficial. Download the leaflet

The need for fast-paced innovation in healthcare is widely acknowledged. And ensuring that healthcare innovation is shaped by the people it serves remains a pressing priority – one made all the more evident by the growing emphasis on health equity in the 10 Year Health Plan. Patient voices are often cited as central to healthcare innovation, yet in practice, those voices can be overlooked or engaged too late in the process. On 26 February, the Health Innovation Network invited patient representatives to join them at HETT North in Manchester. They visited innovators exhibiting with the Health Innovation Network, and were encouraged to share experiences and reflections on Patient and Public Involvement and Engagement, common challenges and best practices. In partnership with The Patients Association, a roundtable discussion was convened to explore how Patient and Public Involvement and Engagement can deliver more inclusive, sustainable healthcare innovation.  What emerged from the roundtable discussion is a comprehensive set of recommendations that outline how sustained, well-structured patient engagement can enable more equitable, impactful and inclusive healthcare innovations. Forging a more equitable future through Patient and Public Involvement and Engagement sets out these recommendations, exploring how patient voices can be embedded in the development of digital technology, the need to move beyond conventional pathways, and how to build trust through local communities. A consistent theme was the emphasis on meeting people where they are. Addressing health inequalities requires acknowledging how social, economic, and cultural contexts shape individuals’ access to—and perceptions of—care. Explore the full report to discover real-world case studies, expert insights and actionable recommendations that can shape the future of patient involvement in healthcare innovation.

The Nuffield Trust and The King’s Fund join forces each year to analyse and present findings from the gold-standard survey of public attitudes and opinions towards the NHS and social care, as surveyed by NatCen. The 2024 survey results show that the British public are deeply unhappy with the way the NHS runs – just 1 in 5 people said they were satisfied. Key findings Satisfaction with the NHS In 2024, just one in five British adults (21%) were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs. This is the lowest level of satisfaction recorded since the survey began in 1983 and shows a steep decline of 39 percentage points since 2019. Only 2% of respondents were ‘very’ satisfied with the NHS, down from 4% in 2023. The percentage of people who were ‘very’ or ‘quite’ dissatisfied with the NHS rose to 59% in 2024, from 52% in 2023. This represents a statistically significant 7-percentage-point increase from the year before, which already had the highest dissatisfaction seen in 40 years of the British Social Attitudes survey. A higher proportion of people in Wales (72%) were dissatisfied with the NHS compared to the survey average and compared to people in England (59%). Supporters of the Reform party were less likely to be satisfied (13%) than the survey average and this was significant after controlling for other variables like age and income. There is a divide between generations, with satisfaction lower and falling in younger age groups. While the proportion of people who were satisfied rose slightly for those aged 65 and over, from 25% to 27%, among those under 65 it fell significantly, from 24% to 19%. Satisfaction with social care In 2024, only 13% of respondents said they were ‘very’ or ‘quite’ satisfied with social care (the same figure as 2023). 53% of respondents were ‘very’ or ‘quite’ dissatisfied. Respondents in Wales (69%) were again significantly more likely to be dissatisfied than the survey average. Satisfaction with different NHS services Public satisfaction with A&E services has fallen sharply, from 31% to just 19%, and dissatisfaction has risen from 37% to 52%. These are the worst figures on record by a large margin and make A&E the service with lowest satisfaction levels for the first time. Satisfaction with NHS dentistry has continued to collapse. As recently as 2019 this was at 60%, but it has now fallen to a record low of 20%. Dissatisfaction levels (55%) are the highest for any specific NHS service asked about. Satisfaction with GP services continued to fall, mirroring the trend over the last few years. 31% of respondents said they were satisfied with GP services, compared with 34% in 2023. Inpatient and outpatient hospital care is the part of the NHS with the highest levels of satisfaction, with 32% saying they were satisfied and only 28% dissatisfied. Attitudes to standards of care, staffing and efficiency The majority of the public (51%) said they were satisfied with the quality of NHS care. People aged 65 and over were more likely to be satisfied (68%) with the quality of NHS care than those under 65 (47%). Dissatisfaction with waiting times and the ability to get an appointment is widespread, and is consistent across respondents from all ages and UK countries: 62% of all respondents were dissatisfied with the time it takes to get a GP appointment. 23% were satisfied. 65% of respondents said they were dissatisfied with the length of time it takes to get hospital care. 14% said they were satisfied. Dissatisfaction levels are highest regarding the length of time it takes to be seen in A&E. 69% of respondents said they were dissatisfied, while just 12% said they were satisfied. Only 11% agreed that ‘there are enough staff in the NHS these days’. 72% disagreed. NHS funding, principles and priorities 8% of respondents said that the government spent too much or far too much money on the NHS; 21% said that it spent about the right amount, and 69% said that it spent too little or far too little. When asked about government choices on tax and spending on the NHS, the public would narrowly choose increasing taxes and raising NHS spend (46%) over keeping them the same (41%). Only 8% would prefer tax reductions and lower NHS spending. Only 14% of respondents agreed that ‘the NHS spends the money it has efficiently’. 51% disagreed with this statement. Respondents felt the most important priorities for the NHS should be making it easier to get a GP appointment (51%) and improving A&E waiting times (49%), with increases in staff (48%) and better hospital waiting times close behind (also 48%). A&E has now slightly overtaken staffing as a priority, reflecting the sharp fall in satisfaction described above. People under 65 were more likely to prioritise improving mental health services (34%) than those aged 65 and over (21%). As in previous years, a strong majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2024: that the NHS should be free of charge when you need to use it (90%); the NHS should primarily be funded through taxes (80%); and the NHS should be available to everyone (77%). The percentage of people saying that the NHS should ‘definitely’ be available to everyone decreased from 67% in 2023 to 56% in 2024. This is the only statistically significant change year-on-year across all three principles. Supporters of the Reform party (20%) were significantly less likely to say that the NHS should ‘definitely’ be available to everyone than the survey average.

We talk about patient-centred care but we don’t have patient-centred systems. Understanding “why this matters” is essential to making progress in creating patient-centred in healthcare systems. #NavigatingHealth is a social impact project effecting health system change. Find out more in this video.

Some hospitals have established a preterm birth pathway to predict, prevent, and prepare for early births. This study reviewed and made suggestions on how best to implement the pathway. These included: better staff training on early birth and the pathway multidisciplinary preterm teams women-centered care.  Obstetricians, midwives, hospital managers, and professional bodies for maternity care could use the findings to improve care.  

Hospital at home and virtual wards provide safe alternatives to hospital care in the community. There is considerable variation in how they are operationalised at a local level. In general, their common feature is to provide healthcare in people’s homes through a multidisciplinary clinical team. Care is delivered both remotely and face to face. They aim to help avoid admission as well as facilitate rapid discharge. The models vary in terms of who leads the service; the hours of operation; the staffing model; the conditions they support; the length of support; how technology is used; and how patients and professionals access the service. In March 2025, NIHR Evidence held a webinar showcasing research on two home-based alternatives to hospital care from three evidence reviews: admission avoidance hospital at home and virtual wards for people with frailty. The webinar addressed: the key elements of hospital at home and virtual wards their impact on outcomes their impact on service costs factors that contribute to their success.

The Leadership Academy has commissioned a project to explore how it can maximise the potential of ‘people power’ through its work, ensuring that participants in its programmes are equipped to work in co-production, across boundaries, and focus on health creation and community capacity, not just how to lead services or organisations. This short primer sets out the theory and context around community development and co-production and what this means for NHS leaders and leadership development. Recommendations from the project will build on what’s already working well across the country and highlight opportunities for change, in order to build an even stronger Academy offer into the future.

There is no surgical procedure which is 100% risk-free of problems. Hospitals, clinicians, consultants, and their teams are fully aware of the responsibility to treat patients safely. However, there are also several things that you can do as a patient to help support you own safety while having a surgical procedure, as outlined in this article from the Private Healthcare Information Network (PHIN).

This brief presents four case studies illustrating how primary care practices can effectively engage with their communities to support whole-person care. Each case study highlights the need identified in the practice or community and the community-based intervention conducted in response, as well as the funding sources, results, and key takeaways. The case studies offer diverse approaches and strategies that primary care teams can use to engage with their communities to address health-related social needs (HRSN) and improve health outcomes. The four case studies include:The CUNA Program, Cherokee Health Systems and Centro Hispano de East TennesseeVietnamese Family Autism Advisory Board, HopeCentral ClinicSupporting Families Growing Together Initiative, MaineHealth SystemOpioid Centers of Excellence Model, Pennsylvania Department of Human Services