NHS logo on the side of a building

Update on the Future Direction of Patient Safety in the National Health Service

Matt Hancock, the Secretary of State for Health and Social Care on February 6 gave a wide-ranging speech on the future direction of patient safety in the NHS. The speech is important as it gives key insights into government priorities for patient safety policy development in the NHS.He stated that we all trust nurses and doctors more than any other profession. He spoke about the importance of a “just culture” in the NHS and openness, honesty, and trustworthiness.

His speech addressed strengthening NHS leadership and the newly published Kark Report on the Fit and Proper Person Test, improving NHS leadership. Independent medical examiners, whistle-blowers and a number of other issues were also discussed. He also spoke about several well-known patient safety crises, saying, “As Health Secretary, I’m sorry to those families in Gosport, Liverpool Community Hospital, Mid Staffs and everyone else who has been let down. But I’m not here today to point fingers and blame people. Instead, we must learn the right lessons about creating a caring, compassionate culture, about protecting and renewing the bond of trust between the public and the NHS – our nation’s most loved and respected institution.”

Clinical negligence

Hancock also spoke about clinical negligence and what happens when mistakes are made in patient care and treatment. He accepted that we all make mistakes and that we should all strive to avoid them, “…but the fact of a mistake isn’t the biggest problem. It’s how we respond to them and how we learn from them, that’s what’s most important. And we must never let our fear of the consequences, stop us from doing the right thing,” he said.

Living our values

Hancock mentioned in his speech an important statement of operational values that one hospital he visited has drawn up and published. The Princess Alexandra Hospital NHS Trust in Harlow, Essex have developed a behavior values charter, “Achieving Excellence, Living our Values.” He praised this as an excellent example of demonstrating, openness, honesty and trustworthiness. This hospital behavior charter sets the scene for patients and their families on the behaviors and the values that can be expected to be demonstrated by the hospital and its staff. It is a public declaration of intent by the hospital and lists core values.

Hancock, in his speech, talked about the new NHS patient safety agenda that is being planned:

“We can’t afford to let it go to waste. There is a moral and financial urgency to act. We must improve patient safety, so there’s:

  • less paperwork for medical staff and more time for patients
  • faster resolution for those who are wronged
  • more money for frontline NHS services and less taxpayers’ money going to lawyers

That’s what I want to see. That’s the approach we’ll be taking in our new patient safety strategy.”

Don’t demonize the lawyers?

His aims for a new patient safety strategy are good and commendable but his comment about, “less taxpayers money going to lawyers,” is a cause for concern. The reference to money going to lawyers sends very mixed messages and not all good ones. Lawyers are a neutral force, they are, as members of highly regulated professions, not spuriously suing the NHS in the hope of financial windfall and gain. Patients are approaching them because they are claiming to have been negligently injured by those who are meant to care for them.


Hancock’s speech on patient safety is to be welcomed, he states clearly the challenges that must be met for the NHS to develop an ingrained patient safety culture. The Princess Alexandra Hospital in Harlow, Essex, UK work on values is also to be welcomed as adding extra velocity to NHS patient safety culture development efforts.

John Tingle

John Tingle is a regular contributor to the Bill of Health blog. I am a Lecturer in Law, Birmingham Law School, University of Birmingham, UK; and a Visiting Professor of Law, Loyola University Chicago, School of Law. I was a Visiting Scholar at Harvard Law School in November 2018 and formerly Associate Professor at Nottingham Law School, Nottingham Trent University in the UK. I have a fortnightly magazine column in the British Journal of Nursing where I focus on patient safety and the legal aspects of nursing and medicine. I have published over 500 articles and a number of leading texts in patient safety and nursing law. My current research interests are in global patient safety, policy and practice, particularly in African health care systems. My most recent publication is: "Global Patient-Safety Law Policy and Practice," edited by John Tingle, Clayton O'Neill, and Morgan Shimwell, Routledge 2018.

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