Search the hub

In this article, Patient Safety Learning reflects on the results of the NHS Staff Survey 2025, focusing on responses relating to reporting, speaking up and acting on patient safety concerns. On 12 March 2026 the NHS published the results of its 2025 staff survey.[1] 729,423 staff from 238 organisations took part in this survey, which provides a snapshot of their experiences of working in the health service. The survey includes several questions on reporting patient safety incidents and near misses, concerns about clinical safety and views on speaking up more broadly. As we set out in this analysis, unfortunately the Staff Survey results suggest there are little signs of positive progress across many of these areas. Reporting of errors, near misses and incidents A high number of survey respondents, 86.16%, answered that their organisation encourages staff to report errors, near misses and incidents. However, 40.71% of respondents (over 290,000 staff) subsequently answered that they were unable to say with confidence that their organisation treats them fairly if they are involved in an error, near miss or incident. Answers to both these questions in the Staff Survey have remained fairly consistent across the past four years, as illustrated by the table and graph below. These results suggest there persists a significant disconnect between what organisations tell staff about reporting patient safety issues, and how staff feel they will be treated if they actually raise concerns. 67.3% of staff said that when errors, near misses or incidents are reported, their organisation takes action to ensure that they do not happen again. Responses to this question have also remained fairly static for the past four years (within a range of 67-69%), with nearly a third of staff consistently feeling unable to answer this question with a positive response. Responses to this question also vary significantly according to Trust type, with Community Trusts scoring highest on average (75.91%) and Ambulance Trusts scoring lowest (54.79%). Connected to this, nearly two-fifths of respondents, 38.98%, did not agree that they are given feedback about changes made in response to reported errors, near misses and incidents. When staff are unable to clearly see that their organisation acts on their safety concerns, it is understandable that they may be less motivated to report these. Concerns about clinical safety When asked about whether they would feel secure raising concerns about unsafe clinical practice, 71.1% of respondents answered this positively. Although this is quite a high percentage, the response rate in 2025 means that over 200,000 NHS employees, 28.9% of survey respondents, could not say that they would feel secure raising such concerns. When asked if they were confident that their organisation would address these concerns, 55.49% of staff responded positively. As illustrated by the table and graph below, responses to both these questions have remained fairly consistent across the last five years. Speaking up about concerns Turning to speaking up about concerns more broadly, 39.71% of survey respondents (over 280,000 staff) could not say that they felt safe to speak up about anything that concerns them in their organisation. As with the questions on reporting incidents, errors and near misses, again the average response varies significantly according to Trust type. When looking at Community Trusts, this figure drops to 30.2% but is significantly higher in Acute and Acute & Community Trusts (41.03%) and Ambulance Trusts (45.53%). When asked about their confidence in their organisation addressing their concern, just over half of all respondents did not express confidence that this would happen. As illustrated by the table and graph below, responses to both these questions have remained more or less consistent over the past five years, with a small decline this year. Safety culture in the NHS The 2025 staff survey results show no significant change in responses to questions on reporting, speaking up and acting on patient safety concerns in recent years. While the survey only provides an annual snapshot of experiences of working in the NHS, its findings suggest that a fear of speaking up and a lack of confidence that concerns will be acted on still persists in too many NHS organisations. These issues form a recurring theme across inquiries into major patient safety scandals.[2] [3] [4] They also can be seen reflected in the shocking experiences and testimonies of whistleblowers, such as those highlighted in our Speaking up for patient safety interview series.[5] Staff being able to raise concerns safely and effectively is essential for patient safety. However, as highlighted in a recent review shared by Roger Kline on the hub, the NHS continues to struggle with creating a culture where this happens reliably.[6] [7] Need for action It was notable that the need to tackle problems relating to safety culture was absent in the 10 Year Health Plan for the NHS, as highlighted in our response to this last year.[8] If the healthcare system is to truly be transformed over the next decade, then we cannot simply proceed by ignoring these issues or assuming they will resolve themselves. At Patient Safety Learning, we believe it is vital that we create a culture in healthcare that supports raising, discussing and addressing the risks of unsafe care. Year on year we highlight the stagnant set of staff survey results in this area because we do not believe the lack of improvement in this area is acceptable. Too often, at a national level, it appears that the extent and persistence of blame cultures in healthcare, and the need to tackle this, are acknowledged but action is not taken to address these significant challenges. It is difficult to imagine that the scale evidence of an unsafe culture in other safety critical industries would be tolerated—where the consequences of not addressing the risk in incidents may also be serious injury or loss of life. We hope that the soon to be published new NHS Quality Strategy will reflect on the importance of this issue and that health system leadership will recognise this issue as an urgent priority.[9] References NHS Staff Survey. NHS Staff Survey National Results. 12 March 2026. The Mid Staffordshire NHS Foundation Trust Public Inquiry. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, 6 February 2013. Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust. Ockenden Report: Findings, conclusions and essential actions from the independent review of maternity services at The Shrewsbury and Telford Hospital NHS Trust, 30 March 2022. Independent Investigation into East Kent Maternity Services. Maternity and neonatal services in East Kent – the Report of the Independent Investigation, 19 October 2022. Helen Hughes and Peter Duffy. Key themes emerging from our ‘Speaking up for patient safety’ interview series. Patient Safety Learning, 14 May 2025. Roger Kline. Power and the sound of silence. Patient Safety Learning, 11 March 2026. Roger Kline. Patient safety and speaking up – learning from the literature. Patient Safety Learning, 11 March 2026. Patient Safety Learning. 10 Year Health Plan: Patient Safety Learning’s response. 14 August 2025. Patient Safety Learning and Aqua. Patient safety and the new NHS Quality Strategy. 25 February 2026.

This report highlights the burden of health care-associated infections (HAIs) and antimicrobial resistance (AMR) and the related harm to both patients and health workers in care settings. It also presents an updated global situation analysis of the implementation of infection prevention and control (IPC) programmes at the national and health care facility levels, including a focus on the WHO regions. Headline points from this report include: On average, out of every 100 patients in acute care hospitals, seven patients in high-income countries (HICs), and 15 patients in low and middle-income countries (LMICs), will acquire at least one HAI during their hospital stay. Almost up to one third (30%) of patients in intensive care can be affected by HAIs, with an incidence that is two to 20 times higher in LMICs than in HICs, in particular among neonates. One in four (23.6%) of all hospital-treated sepsis cases are health care-associated and this increases to almost one half (48.7%) of all cases of sepsis with organ dysfunction treated in adult intensive care units. In 2023–2024, according to the system established to monitor the status of country progress towards the implementation of the AMR global action plan (the Tracking AMR Country Self-assessment Survey), 9% of countries did not yet have an IPC programme or plan. Only 39% of countries had IPC programmes fully implemented nationwide, with some being monitored for their effectiveness.