Source · Select Committees · Public Accounts Committee
Recommendation 10
10
Accepted
Patient safety system suffers from duplication and minimal improvement amidst reforms.
Recommendation
The NHS reports around 2.4 million patient safety incidents annually, most of which (70%) cause no harm to patients, but around 0.5% of patient safety incidents result in severe harm or death. The 2025 Dash review identified considerable overlap and duplication in the current patient safety landscape with relatively little improvement over the last five to 10 years.12 The Department told us it had set out a new plan to oversee quality and safety as part of the 10-Year Health Plan,13 but did not outline any of the specific measures it will take to achieve this.14 In 2025 the Department announced the planned abolition of NHS England and the Health Services Safety Investigations Body.15 NHS England told us that there is a lot of change going on and it is working to rationalise the patient safety system but that it must take a cautious approach to ensure important functions are not lost.16 The NHS is being asked to find at least £1 billion in savings over the next three years. The ambition is to reduce central staff numbers by up to 50% across the Department, NHS England and Integrated Care Boards by March 2028 and is expected to cost between £1 billion and £1.3 billion.17
Government Response Summary
The government states that the NHS Patient Safety Strategy (2019) already provides a national framework. They will update this strategy in 2026.
Government Response
Accepted
HM Government
Accepted
2. PAC conclusion: The NHS has not done enough to tackle the underlying causes of harm to patients. 2a. PAC recommendation: The Department must set a national framework for improving patient safety with clear targets for annual improvement. 2.1 The government agrees with the Committee’s recommendation. Recommendation implemented 2.2 The government is committed to improving patient safety across the NHS and tackling the underlying causes of harm to patients, and has implemented a national framework, detailed below. 2.3 The NHS Patient Safety Strategy (2019) sets a national framework for the NHS to improve patient safety continuously. The Strategy is clear that while it is not possible to set a single annual target for safety, it has demonstrated that identifying priority areas and focussing on effective improvement programmes can improve safety and reduce harm. 2.4 The Strategy has been in operation for over six years. NHS England estimate that it is now achieving the impact it estimated in 2019; saving around 1,000 lives and £100 million annually. Significant achievements across the Strategy’s national patient safety programmes include over 1500 neonatal lives saved, over 500 cerebral palsy cases in premature babies avoided, more than 1900 deaths prevented through medicines safety improvements and over 1700 potentially lifesaving interventions made following Martha’s Rule calls. 2.5 However, the government accepts there is much more to do, particularly in the current context of system pressures and demographic change. This means the ability to apply evidence-based, just and effective patient safety principles, as part of a wider approach to quality, is more important than ever. 2.6 The development of a Quality Strategy and a revitalised National Quality Board are key components of the government’s 10 Year Health Plan. Once the Quality Strategy is published work will begin to develop a new, updated NHS Patient Safety Strategy later in 2026 to continue the focus on improving patient safety.