A priority for all health innovation networks, a focus for specific projects
The safety of patients is a critical thread running throughout all of our programmes of work.
In addition, we deliver patient safety specific programmes covering a multitude of care settings including acute care, maternity and neonatal units, mental health trusts, primary care, community and care homes. These all link to the NHS England National Patient Safety Improvement programme, which focuses on improving the safety of patients across systems.
A strategy for safety
Our health innovation networks and the Patient Safety Collaboratives (PSCs) they host are making an important impact on the NHS’s Patient Safety Strategy. This is down to the PSCs’ work supporting National Patient Safety Improvement Programme delivery and focus on encouraging the spread and uptake of innovation.
Patient safety in partnership: Our plan for a safer future 2019-2025 has been developed in line with the NHS Patient Safety Strategy , published in 2019, detailing how we aim to work more closely with health and care organisations to improve safety in both hospitals and community-based services.
Our patient safety plan 2024, Patient safety in partnership is our fifth update capturing the impact we’re having. It gives examples of a range of projects helping to translate the commitments of the NHS Patient Safety Strategy into practical activity ‘on the ground’.
Patient Safety Collaboratives
PSCs are funded and nationally coordinated by NHS England and hosted locally by regional health innovation networks.
The PSCs are making their impact by identifying and rolling out safer care initiatives within the NHS and industry, ensuring these are shared throughout the health and care system.
To do so, they deliver the National Patient Safety Improvement Programmes (NatPatSIP) – a key part of the NHS Patient Safety Strategy – collectively forming the largest safety initiative in the NHS in its near century-long history.
The PSC teams are experts in supporting quality improvement projects using the Institute of Healthcare Improvement (IHI) model for improvement. Download the PSC quality improvement resource pack to find out more.
Martha’s Rule
The Health Innovation Network are the implementation partners for Martha’s Rule through their Patient Safety Collaboratives.
The purpose of Martha’s Rule is to provide a consistent and understandable way for patients and families to seek an urgent review if their or their loved one’s condition deteriorates, and they are concerned this is not being responded to. Martha Mills died in 2021 after developing sepsis in hospital. Martha had been admitted with a pancreatic injury after falling off her bike whilst on holiday. Martha’s family concerns about her deteriorating condition were not responded to on several occasions and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier. Martha’s mother, Merope Mills, has been active in supporting change. You can listen to her speaking on BBC Radio 4’s Woman’s Hour, read Martha’s full story, and learn Merope’s thoughts on Martha’s Rule.
In response to this and other cases related to the management of deterioration, the Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’; to ensure the vitally important concerns of the patient and those who know the patient best are listened to and acted upon.
In April 2024, national implementation of Martha’s Rule began. NHS England announced in May 2024 that 143 hospital sites across England will be rolling out Martha’s Rule.
Once NHS hospitals have fully implemented all components, patients, families, carers, and staff will have round-the-clock access to a rapid review from a separate care team if they are worried about someone’s condition.
Martha’s Rule has three components:
NatPatSIP aims
The core objective of the programmes is to support NHS organisations in adopting safety interventions and strategies, learn from excellence, and to support systems to continually improve – continually reducing error, harm and death, to make the NHS comparable with the safest health care services in the world by 2025.
Each PSC works with its local Integrated Care System (ICS) to develop and distribute innovative improvement methods, which are systematic, evidence-based and measurable.
The NatPatSIP’s current work focuses on these safety improvement programmes (download the driver diagram):
Managing deterioration
Together, we will reduce deterioration-associated harm by improving the planning, identification, escalation and response (PIER) to physical deterioration.
Maternity and neonatal safety
Together, we will improve the safety and outcomes for all women, babies, and families across maternity and neonatal care settings in England.
Medicines safety
Together, we will reduce the severe harm and death associated with medicines by 50% over five years.
System safety
Together, we will create optimal conditions for patient safety improvement across systems.
Key enablers
The delivery of the five safety programmes is shaped by key enablers:
- Patient and staff co-development
- Achieving patient safety equity
- Positive safety climate and culture
- Transformational improvement leadership
- Building effective patient safety and quality improvement capacity and capability
Get in touch
Contact your local health innovation network patient safety team to access support or more information on the safety programmes.
