24th July 2026

CEO Blog: A welcome vision for NHS quality — but what happens when harm occurs?

The new NHS quality strategy contains important ambitions. Its success will depend on aligned incentives, clear accountability, and a better response to people harmed by healthcare.

NHS England’s new Quality Strategy for NHS-Funded Care in England sets a welcome ambition: to make quality the organising principle of NHS care over the next decade.

The strategy rightly treats safety, effectiveness, and patient experience as interdependent. It also contains important commitments to transparency, listening to patients, and using feedback to drive improvement.

Dependencies are critical to its success

Its success, however, depends on an extraordinary number of organisations working together — namely, NHS England, the Department of Health and Social Care, integrated care boards, providers, regulators, professional bodies, local authorities, and others.

‘Shared responsibility’ is necessary, but it can mean blurred accountability. Aligning the priorities, resources, and incentives of so many bodies will be a substantial delivery risk. The strategy itself recognises this by making the alignment of incentives one of its ten essential enablers. The test will be whether responsibilities are translated into funded, measurable action.

Complaints reform is a critical opportunity

We particularly welcome the commitment to reforming complaints regulation and processes so the NHS can learn more effectively from complaints. This is critical, as so many of the people we support report clear failings in the complaints process as it operates today. But the strategy offers little detail about what this reform will mean for patients.

A better system must be simpler, more independent, and timely. It should also ensure that people can access independent advocacy where they need it, so they are properly supported to navigate the process and secure meaningful answers and remedies, not merely contribute intelligence for organisational learning.

Using better tools to analyse data can help prevent harm

We also welcome plans to evaluate AI tools to analyse reports submitted to the Learn from Patient Safety Events (LFPSE) system. Used with appropriate safeguards and human oversight, AI could identify patterns and emerging risks that would otherwise remain hidden.

A significant omission

There is, nevertheless, a significant omission. The 2019 NHS Patient Safety Strategy acknowledged that ‘it is human to make mistakes’ and that safety is not absolute. The new strategy concentrates almost entirely on preventing and learning from harm. It says very little about what the NHS owes people after harm has occurred.

Even the safest healthcare system cannot eliminate every instance of harm. Quality must therefore include a compassionate, open, and properly coordinated response: acknowledgement, explanation, practical support and action to avoid compounding the original harm. That should be an explicit part of the strategy — and of the forthcoming refresh of the Patient Safety Strategy. Not only is this the morally right thing to do, but it would almost certainly reduce the total impact of harm and save money on reduced litigation, as undoubtedly people are seeking early explanations and answers to their concerns which, when not provided, drive some to legal remedies.