Search the hub

Fatigue is widely accepted as a feature of working life across healthcare. Long hours, shift work and high workload mean that many staff regularly experience some degree of fatigue. Fatigue is associated with increased risk of error and reduced performance and therefore has negative impacts on both patient safety and staff wellbeing. Fatigue is also linked to broader workforce challenges including staff physical and mental health, burnout, absenteeism and retention. Although these risks are well documented, the extent to which they are addressed through structured and systematic approaches within healthcare remains less clear. The Clinical Human Factors Group recently reviewed the literature to explore how fatigue is currently managed across healthcare and what strategies are being used in practice. The findings provide an overview of how fatigue is understood and addressed and highlight a gap between the well-established risks associated with fatigue and the ways in which those risks are mitigated in practice.

We talk about resilience, efficiency, and ‘just getting through the day’. But behind closed doors, many GPs are working at a pace and intensity that is simply not safe. Many who have felt pushed to the brink: overwhelmed, burnt out, and questioning whether they can continue. That isn’t just a few isolated GPs; the data suggests this feeling is widespread across the profession. In Nottinghamshire, the local medical committee developed a safe working charter to support this shift in thinking. It’s not a prescriptive checklist, but it offers practical ways practices can start to embed safer ways of working. It focuses on two key areas: workload control and practice systems.

Racism and other forms of discrimination not only affect people receiving care, but also many midwifery and nursing professionals who provide it. Everyone deserves to receive equitable, culturally safe, anti-racist, unbiased care. Students and nursing and midwifery professionals deserve to learn and work in psychologically safe environments where discriminatory behaviours and biases are called out, challenged, and not tolerated. Anti-racism is fundamental to patient safety and public protection. The Nursing and Midwifery Council (NMC) anti-racism principles set out some of the ways educators, organisations, registrants and employers can address concerns around inequities in care and racism across health and social care practice, education, and regulation. The principles are designed to: Strengthen cultural safety, curiosity and respect in practice and education Explicitly advance meaningful, sustained anti-racist, bias-aware practice. The principles are organised around four areas. Culture, equity and inclusion. Learning, education and workforce development. Community and person-centred practice. Assurance, accountability and sector improvement.

This Health Services Safety Investigations Body (HSSIB) report is intended for healthcare organisations, policymakers and the public to help improve patient safety in relation to safety issues identified for people experiencing a mental health crisis who come into contact with urgent and emergency care services. This report focuses on the significant legal, policy and safety gap in the care of people in emergency departments (EDs) in mental health crisis. During consultation on this report, concerns were shared with HSSIB about the current challenges in relation to the resourcing and configuration of mental health services that exacerbate challenges faced in the ED. This is the first of two reports. In October 2025 HSSIB launched two investigations that explore the safety issues for people experiencing a mental health crisis who come into contact with urgent and emergency care services. This interim report was produced due to the early identification of a significant legal, policy and safety gap in the care of people in emergency departments (EDs) in mental health crisis. It is reported that around 3% of all ED attendances are mental health related. However, people experiencing mental health problems are twice as likely as other patients to remain in the ED for more than 12 hours. People in mental health crisis may need to be assessed for admission to a mental health hospital in line with the Mental Health Act 1983. Delays in these assessments being undertaken, and/or the lack of availability of mental health inpatient beds once a person has been recommended for admission, can lead to patients remaining in EDs for prolonged periods. Findings There is an absence of clear legal powers to lawfully prevent vulnerable individuals from leaving the ED while awaiting assessment or admission. This legal ambiguity exposes patients to increased risk of harm and/or being unlawfully deprived of their liberty, and places staff in a position of uncertainty when attempting to manage safety. For those requiring formal admission to a mental health hospital, an application under the Mental Health Act 1983 cannot be completed until a bed has been identified, which can take days. Staff and organisations reported they are often faced with choosing “the least harmful way to break the law” in order to try and keep patients safe. EDs are not designed to provide therapeutic mental health care and prolonged stays may worsen patients’ conditions and create challenges in maintaining a safe environment for everyone. HSSIB makes the following safety recommendations: HSSIB recommends that the Department of Health and Social Care urgently reviews the current legal framework and addresses the current legislative gaps in emergency care for people in mental health crisis and clarify the extension of legal powers for health professionals to hold someone in the emergency department. This will safeguard people who are currently arriving at the emergency department in a mental health crisis and the staff who care for them to support safe, consistent and legally compliant care. HSSIB recommends that the Care Quality Commission works with stakeholders to produce a position statement on existing legal powers, and the expectations for support for staff, for the care of people experiencing a mental health crisis in emergency departments (including mental health emergency departments and mental health crisis assessment services), who are not detained under a formal legal framework. This should include a review of current guidance and existing powers to help support safe, consistent, and legally compliant care in the absence of comprehensive legislation, while minimising harm and addressing the unique challenges of prolonged stays in the emergency department.

Psychological safety is essential for open communication in the workplace, learning and high performance. Despite this, many business owners and HR professionals don’t know how safe their team truly feels to speak up, share ideas or admit mistakes.  A psychologically safe workplace survey helps you measure this, uncover barriers and find opportunities to build trust and collaboration. Employment Hero have designed a psychological safety survey template to make it easy for you to measure psychological safety within your teams and take action to build a more open, supportive and high-performing workplace. Here’s what you’ll find: An overview of psychological safety. Survey instructions. Ready-to-use survey questions. Open-ended reflection questions. Action planning guide. Tips for building psychological safety.

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

On 25 February 2026, healthcare leaders and stakeholders gathered in London for the Patient Safety Forum, organised by Public Policy Projects (PPP) in partnership with Patient Safety Learning. This blog summarises two sessions at this event which explored how the patient voice can meaningfully contribute to service improvement, and why better care is contingent on a supported, healthy workforce. Read the full article from PPP via the link below.

Like everyone, health workers deserve the right to pursue mental health care without fear of losing their job. However, overly invasive mental health questions in licensing and credentialing applications prevent health workers from seeking support and are a primary driver of suicide in the healthcare workforce. Such questioning tends to be broad or stigmatizing, such as asking about past mental health care and substance use treatment, which has no bearing on a health worker’s ability to provide care and may violate the Americans with Disabilities Act. The Dr Lorna Breen Heroes' Foundation’s mission is to reduce burnout of health care professionals and safeguard their well-being and job satisfaction. We envision a world where seeking mental health services is universally viewed as a sign of strength for health care professionals. The Foundation has three main bodies of work targeted at making a long-standing impact on this issue: Advising the health care industry to implement well-being initiatives. Building awareness of these issues to reduce the stigma. Funding research and programmes that will reduce health care professional burnout and improve provider well-being.

With the UK Covid-19 Inquiry due to publish its report into the impact of the pandemic on healthcare systems this week, CATA (the Covid Airborne Transmission Alliance) has submitted its own reports to the Inquiry. These cover investigations that CATA carried out independently, based on Freedom of Information requests and other sources of information (see CATA's press release that explains the background to this initiative). David Osborn, a member of CATA's Executive Team, gave a brief overview of these reports in a presentation to the SHBN (the Safer Healthcare Biosafety Network). David Osborn SHBN Meeting 130326.mp4 David's presentation can also be downloaded from the PDF attachment below: 2026-03-13 SHBN Meeting.pdf CATA has released copies of their reports into the public domain although, due to Inquiry confidentiality rules, some material has had to be redacted. Links to CATA’s two reports: Changes in the Management of COVID-19 (March 2020) Independent Investigation into the conduct of the IPC Cell

The NHS Staff Survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. Over 1.5 million NHS employees in England were invited to participate in the survey, with 729,423 staff responding in 2025. Responses to key patient safety questions in this year’s survey included: Reporting of errors, near misses and incidents 33.71% of staff have seen errors, near misses, or incidents that could have hurt staff and/or patients/service users in the last month (2024: 33.64%; 2023: 33.50%; 2022: 33.72%). 59.29% of staff said their organisation treats staff who are involved in an error, near miss or incident fairly (2024: 59.72%; 2023: 59.51%; 2022: 58.22%). 86.16% of staff said their organisation encourages staff to report errors, near misses or incidents (2024: 86.43%; 2023: 86.41%; 2022: 86.14%) 67.30% of staff said that when errors, near misses or incidents are reported, their organisation takes action to ensure that they do not happen again (2024: 68.19%; 2023: 68.20%; 2022: 67.40%) 61.02% of staff said that they are given feedback about changes made in response to reported errors, near misses and incidents (2024: 61.28%; 2023: 61.03%; 2022: 59.89%). Concerns about clinical safety 71.10% of staff said they would feel secure raising concerns about unsafe clinical practice (2024: 71.56%; 2023: 71.47%; 2022: 72.07%; 2021: 75.17%). 55.49% of staff said they were confident that their organisation would address their concern (2024: 56.82%; 2023: 56.86%; 2022: 56.75%; 2021: 59.52%). Speaking up about concerns 60.29% of staff said they feel safe to speak up about anything that concerns them in their organisation (2024: 61.83%; 2023: 62.35%; 2022: 61.54%; 2021: 62.08%). 47.59% of staff said they were confident that their organisation would address their concern (2024: 49.51%; 2023: 50.06%; 2022: 48.66%; 2021: 49.77%). Care for patients and service users 71.78% of staff said that care of patients or service users is their organisation's top priority (2024: 74.37%; 2023: 75.14%; 2022: 74.05%; 2021: 75.62%). 69.18% of staff agree that their organisation acts on concerns raised by patients or services users (2024: 70.90%; 2023: 70.62%; 2022: 69.15%; 2021: 72.10%) Workload and resources 46.51% of staff said they are able to meet all the conflicting demands on their time at work (2024: 47.20%; 2023: 46.53%; 2022: 42.79%; 2021: 42.85%). 56.06% of staff said they have adequate materials, supplies and equipment to do their work (2024: 58.01%; 2023: 58.33%; 2022: 55.45%; 2021: 57.15%). 32.82% of staff said there are enough staff at their organisation for them to do their job properly (2024: 33.98%; 2023: 32.24%; 2022: 26.21%; 2021: 26.89%).

When we look at the many published patient safety reports the focus is often on the patient and safeguarding their interests. This is to be expected, but it is only a part of a much larger picture. When a patient is injured through an adverse incident there will also be an emotional impact on the health professional involved. The fact that a patient has suffered harm in their care is at odds with what they set out to do. The incident will be devastating for the health professional, and they will also need support. In this article for the British Journal of Nursing, John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, considers recent reports looking at violence against healthcare staff and the adverse impact of corridor care on NHS employees.