Workforce and patient safety

NHS England acknowledges the concerns raised by the HSSIB report and is currently undertaking work to enhance digital clinical safety and address HSSIB’s recommendation. NHSE has undertaken a considerable amount of work to enhance the safety of such products. In line with the commitment made in the National Digital Clinical Safety Strategy (2021), NHS England is reviewing its approach to the delivery of digital clinical safety training. One of the aims of the review is to improve awareness and understanding of digital clinical safety that supports capacity and capability across the NHS in England, both in healthcare providers and ICBs, to support them in identifying and managing digital clinical safety risks. Additionally, NHSE’s Digital Clinical Informatics Safety Team already offers online and in-person digital patient safety training which is tailored to the specific needs of requesting organisations and supports them in effectively fulfilling their responsibilities. The Digital Clinical Informatics Safety Team have recently undertaken a detailed review of the assurance process related to one of the online consultation tools that was made available from the ‘Online Consultations Frameworks’ portfolio to assess the robustness of the assurance process. This retrospective review showed that the assurance process was robust when considered in line with current assurance procedures. Additionally, regular review of some updated NHSE products occurs, and the Digital Clinical Safety Team are currently designing a new strategic approach to the review of all live NHSE products and those assured under historical frameworks. NHS England has recently commenced work to review and modernise the Digital Clinical Safety Standards – DCB0129 and DCB0160 . These mandatory standards are in place to ensure that healthcare IT suppliers and NHS organisations (including primary care providers) follow structured clinical risk management processes to identify, assess, and mitigate risks associated with digital health technologies both when the products are deployed and throughout their life cycle. The key intention of the consultation is to ensure relevance, effectiveness, improve usability, enhance alignment with broader NHS policies and prepare for future risks in new and emerging digital healthcare products. This will include developing an understanding of safety work needed in relation to AI-based products. Pre-consultation focus groups are currently underway, and views are being sought specifically from primary care and ICB colleagues. This work builds on NHS England’s Primary Care Patient Safety Strategy published in September 2024 that outlines specific roles and responsibilities within primary care for digital clinical safety. The Digital Clinical Informatics, Patient Safety and Primary Care teams in NHS England have discussed evaluation of online consultation tools and recognise the importance such an evaluation might bring. NHS England has close links to research centres where this kind of work takes place (such as the Health Foundation’s Improvement Analytics Unit) but is not funded to undertake such an evaluation directly. Therefore, our ongoing activities are focused on the points listed above. NB recent announcements to abolish NHSE and merge functions with the Department of Health and Social Care may have an impact on the work planned. These impacts, if any, are not yet clear. Actions planned to deliver safety recommendation: Review the Digital Patient Safety Strategy to ensure that training meets the needs of both ICBs and Healthcare Providers alike, by Winter 2025. Organisational lead: Deputy Director for Patient Safety NHSE. Other dependencies identified: Major NHSE and DHSC strategic changes 25-26. Publication of the new DCB standards, by Autumn 2026. Organisational lead: CCIO NHSE. Development and implementation of an enhanced ‘live’ product review process, by Autumn 2025. Organisational lead: CCIO NHSE. Other dependencies identified: Major NHSE and DHSC strategic changes 25-26. Exploring mechanisms for procuring and/or initiating an evaluation of safety of care delivery using online tools, by Autumn 2025. Organisational lead: Deputy Director for Patient Safety NHSE. Other dependencies identified: Major NHSE and DHSC strategic changes 25-26. Response received on 6 November 2024. -------------------------------------------------- May 2026: HSSIB has been notified by the NHS England that all actions have been completed.

Summary response We accept the recommendation to review and evaluate the care co-ordinator role. This role is well established in general practice, with over 4,900 care co-ordinators employed through the Additional Roles Reimbursement Scheme under the Network Contract DES. The Workforce Development Framework for Care Co-ordinators outlines scope, boundaries, and minimum training requirements. However, reviewing the care co-ordinator role alone will not lead to a 24/7 single point of contact for patients. Care co-ordination spans health and care sectors, pathways, teams, specific patient cohorts, and is often led by the most appropriate professional. For example, children with epilepsy should have their care co-ordinated by epilepsy specialist nurses. Commitments outlined in the 10 Year Health Plan for England will support improvements in care co-ordination, and 24/7 support for patients. The plan outlines how Neighbourhood Teams will deliver personalised, co-ordinated care via multidisciplinary teams. This includes but it not limited to: People with complex needs will have an agreed care plan. Everyone will have a virtual assistant to provide 24/7 advice and guidance via the NHS App. My NHS GP tool will provide a single, trusted source of instant advice for patients who need non-urgent care, available 24/7. A Single Patient Record (SPR) will make sure patients get seamless care no matter where they are in the NHS. Exploration of technology to increase clinical capacity could give the NHS an opportunity to tap into global talent, deliver 24/7 access and increase productivity. Workforce transformation is key to the ambitions of the 10 Year Health Plan, which recognises care must be locally led by pioneering neighbourhood health teams focusing on patients with multiple long-term conditions. Workforce models will be designed to be integrated, and proactive to ensure that teams have the skills and roles to effectively co-ordinate care for people with multiple long-term conditions. Actions planned to deliver safety recommendation: Continue to further promote existing materials that support implementation of care co-ordinators in primary care, by Autumn 2025. Other dependencies identified: Work of Primary, Community, Vaccinations & Screening (PCVS) including Neighbourhood Health. Review the workforce development framework, and any associated training, for care co-ordinators to ensure alignment with the 10 Year Health Plan, work underway by March 2026. Other dependencies identified: 10 Year Health Plan. Work of Primary, Community, Vaccinations & Screening (PCVS) including Neighbourhood Health. Engage with Neighbourhood Teams to identify and respond to local workforce development needs, including training and upskilling to embed effective multidisciplinary teams (MDTs) delivering coordinated care at neighbourhood level, by 2025/26. Other dependencies identified: Work across NHS England directorate including community services and Urgent and Emergency Care. By 2027, 95% of people with complex needs will have an agreed care plan, by 2027. Other dependencies identified: 10 Year Health Plan. Work across the Department of health and social care supported by NHS England teams for oversight and delivery. By 2028, patients will be able to see who is involved in their care, communicate with professionals directly, draft and view their care plans, by 2028. Other dependencies identified: 10 Year Health Plan. Work across the Department of health and social care supported by NHS England teams (including leadership from digital teams) for oversight and delivery. Publication of 10 Year Workforce Plan, by 2025/26. Launch the National Neighbourhood Health Implementation Programme, by Summer 2025. Other dependencies identified: Yes Wider X-HMG initiatives. Response received on 21 July 2025.