Source · Select Committees · Public Accounts Committee
Recommendation 11
11
Accepted
Unknown but significant cost of avoidable patient harm to health services.
Recommendation
The cost to health services of treating cases involving clinical negligence specifically or cases of avoidable harm to patients is unknown. The Organisation for Economic Co-operation and Development estimates that treating cases where harm was avoidable costs developed countries 8.7% of their health expenditure each year, on which basis the costs in England could run to tens of billions.18 Both the Department and NHS Resolution told us the most important thing is therefore to prevent 10 Q 97 11 Qq 61, 64, 75, 85, 100 12 C&AG’s Report, paras 1.2, 1.4 13 Fit for the future: 10 year health plan for England, July 2025 14 Q 97 15 C&AG’s Report, Figure 1 16 Q 94 17 Billions to be redirected back into patient care with NHS reform - GOV.UK; and Letter from DHSC, dated 11 December 2025 18 C&AG’s Report, para 13 11 harm from happening to patients in the first place.19 NHS England told us it is making considerable efforts around patient safety and that there is no evidence that the levels of harm are increasing.20
Government Response Summary
The government agrees to set a national framework for improving patient safety, but claims the NHS Patient Safety Strategy (2019) already sets such a framework and is achieving significant impact.
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.