HSJ hosts the Patient Safety Watch newsletter, written by Patient Safety Watch chair Jeremy Hunt

Good afternoon, and welcome to this fortnight’s edition of the Patient Safety Watch Newsletter. After a slightly longer gap than usual due to Easter, it’s a packed issue, so let’s get straight into it.

New Women’s Health Strategy launched

The big news this week has been the relaunched England’s Women’s Health Strategy, with a renewed focus on tackling the long-standing gaps in how women experience care. The strategy acknowledges that too many women feel unheard or dismissed, with commitments to faster diagnosis for conditions such as endometriosis, improved pain management, and better access to care.

For us in patient safety, the most welcome shift in the new strategy is the recognition that patient experience must carry real weight. Plans to roll out patient-reported experience measures (PREMs) that will be linked to financial incentives – including new “patient power payments” – means funding will be withheld where there are poor care experiences.

The motives are right, but I am very cautious about tying money to targets, as it usually leads to widespread gaming. Better would be to make sure every woman has her own GP who takes responsibility for making sure she gets the care she needs. Given that the majority of the GP workforce is now female, you would think that would have a real chance of finally turning the dial on women’s health issues.

Funding reform debate misses the point

An interesting new report from the Institute for Public Policy Research looks at the vexed question of whether we should change the NHS’s funding model. It’s an issue that needs more discussion and a very good paper.

Across 22 high-income countries, the report’s authors found no clear advantage of insurance-based systems over tax-funded models. The real issue is outcomes: the UK continues to lag behind peers in key measures, including treatable mortality, alongside ongoing pressures on waiting times and access.

Where the report is weaker is in solutions. It points to underinvestment in capacity – with fewer beds, less diagnostic equipment and weaker capital investment than comparable countries – but doesn’t really explain why that squares with us being the fifth highest (out of 38 OECD countries) in terms of the proportion of GDP we invest in health.

In general, social insurance systems have shorter waiting times but a bigger difference in care received by the rich and the poor. Changing from one system to another is fraught with complex politics, so I personally advocate learning what we can from other single-payer systems, particularly in Scandinavia.

Maternity Incentive Scheme evaluation

An independent evaluation of NHS Resolution’s Maternity Incentive Scheme – which I established as health secretary to link funding with safer care – finds it has been effective in driving leadership attention but less so at improving frontline care. While the scheme has helped unlock investment and prioritisation, the evaluation found it also created a significant administrative burden, with some clinicians describing compliance as an “industry” that risks detracting from patient care.

NHS Resolution has set out reforms to the scheme for 2026, streamlining the scheme to six core areas and shifting the focus towards outcomes, patient experience and equity.

A new Health Services Safety Investigations Body (HSSIB) report exposes a serious gap in the law affecting patients in mental health crisis – that no clear legal power prevents vulnerable individuals from leaving accident and emergency while awaiting assessment or admission. This leaves clinicians facing impossible choices – as one put it, having to find “the least harmful way to break the law” to keep patients safe.

For those requiring admission, delays in finding a mental health bed – often lasting days – mean patients can remain in emergency departments that are not designed to provide therapeutic care, increasing distress and risk for both patients and staff. Action please!

And some trust-level patient safety issues…

Children left for weeks in A&E

As reported by HSJ, a stark case from east London underlines the pressure on services for vulnerable children. At Barking, Havering and Redbridge University Hospitals Trust’s Queen’s Hospital, one child spent more than 70 days in A&E after a care placement broke down, while another waited more than 30 days. Children with complex mental health and behavioural needs are increasingly ending up in emergency departments because there is nowhere else for them to go. Another one for sustained ministerial attention.

Yeovil maternity unit set to reopen after safety closure

As reported by the BBC,  Yeovil District Hospital’s maternity services are set to reopen next week, nearly a year after being closed over safety concerns. The closure, which included the special care baby unit, followed issues such as understaffing and surrounding learning from serious incidents. The trust said these have now been addressed.

IT failures in breast cancer service raise safety concerns

As reported by HSJ, a Royal College of Radiologists review has identified serious patient safety risks in County Durham and Darlington Foundation Trust’s breast cancer service, linked to poor IT systems. Incidents included the wrong patients being scanned, the wrong side being examined, and clinicians being unable to access prior imaging, leading to delays, incomplete records, and missed or misdirected findings.

Cancer patients harmed by admin failures in overwhelmed service

At least eight cancer patients were harmed – and in some cases may have died – due to administrative failures in East Kent Hospitals University FT’s urology department. A review, released to HSJ after a Freedom of Information request, highlighted missed follow-ups, failure to act on results, and no effective system to track patients, leading to significant delays in diagnosis and treatment.

Documents seen by HSJ also showed delays in the harm reviews being carried out, confusion over what was being asked of the staff involved, and poor turnout at meetings to discuss the problems as they were arising.

Ockenden to lead Sussex maternity review

Donna Ockenden has been appointed to lead her fourth independent review into maternity services – this time at University Hospitals Sussex FT. The investigation, commissioned by health secretary Wes Streeting, will examine experiences of bereavement, injury and failures in care. Families have welcomed the appointment, describing it as a significant step after a long campaign for answers.

But more positively…

Action against Medical Accidents chief executive Paul Whiteing has written a timely and thoughtful blog, reflecting on why independence in patient safety organisations truly matters. Drawing on the debate around HSSIB and its proposed move under the Care Quality Commission, he makes a clear case that independence is essential to earning trust and speaking honestly about harm. Well worth a read.

That’s about all for this edition. Before signing off, a quick mention that both James and I are joining thousands of others in running the London Marathon at the end of the month. I am running to raise funds for Sarcoma UK in memory of my brother Charlie and James to raise funds for the fantastic charity Baby Lifeline. Any support is welcome, and wish us luck on the big day!

That’s all for this edition. Please look out for the next edition of the newsletter from James in a fortnight.

Jeremy

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