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Ahead of World Patient Safety Day 2026, Molly Hopson, senior research associate at Picker, says that for a safe NHS, we need to listen to the people accessing and using services.
Currently, around one in every ten patients globally are harmed by unintended or unexpected events during the provision of health care, and more than three million deaths occur annually due to unsafe care practices. In the past three years, 9.7% of British adults reported harm from NHS care or lack of access to care. To tackle this, there is ongoing work across the sector to improve safety by reducing avoidable harm and by minimising adverse events and medical errors. Thursday, 17 September marks World Patient Safety Day 2026, established by the World Health Organization (WHO) to bring together service users, providers, and governments in advocating for patient safety.
In England, the NHS launched its Patient Safety Strategy in 2019 to “build on the foundations of a safer culture and safer systems” and has recently provided a progress update outlining some improvements that have taken place since its rollout. This summer, the health service also published its Quality Strategy, which reaffirmed that the definition of quality care is centred on three core domains – safety, effectiveness, and experience.
To mark World Patient Safety Day, we reflect on what available data on patient and staff experience tells us about patient safety in the NHS in England, and what the link is between patient safety and experience.
Understanding patient and staff experiences
Evidence shows that there continue to be challenges with patient safety within health care environments. According to the NHS Adult Inpatient Survey 2025, 9% of respondents felt like there were “never” enough nurses on duty to care for them in hospital and 35% did not feel they were “always” able to get a member of staff to help when they needed attention. Simultaneously, staff confidence in raising concerns has fallen to its lowest level in five years. According to the NHS Staff Survey 2025, there has been a decline in both the proportion of staff who feel safe speaking up about concerns within their organisation and the proportion who are confident that their concerns will be addressed. More needs to be done to improve care safety for service users and to ensure that staff feel safe and confident in speaking up about their concerns.
Picker has recently explored the relationship between patient experience and safety. In a paper this year, we conducted a systematic review of the literature to examine evidence of any associations. Following the screening of 117 papers from around the world, 30 studies were included in the full review, which found mixed evidence regarding the association between patient experience and patient safety. While some studies identified clear links between the two, others reported considerable variation, often depending on the measures used.
Where studies focused on overall measures of patient experience, results were polarised; most studies that reported consistent associations, and all six studies that found no associations, focused on measures of overall patient experience. By contrast, studies that found more variable associations tended to examine specific dimensions of experience, most commonly the Picker Principles of “Effective treatment by trusted professionals” and “Clear information, communication, and support for self-care”.
These findings suggest that the relationship between patient experience and safety is complex and may vary across different domains of care. Some aspects of people’s experiences appear to be more closely linked to safety than others. As a result, reducing patient experience to a single question or composite measure may obscure important nuances and overlook meaningful insights into the connections between experience and safety.
Importantly, no study found that poorer patient experience was associated with better patient safety, or vice versa. Results suggest that initiatives to enhance patient experience are compatible with efforts to improve patient safety. Consequently, patient experience and safety should not be viewed as competing priorities: rather, they coexist, and improvements in each area can be complementary.
Improving patient safety
While World Patient Safety Day 2026 highlights the continued importance of improving patient safety, this commitment extends far beyond a single day. Patient safety must remain a constant priority, as it is fundamental to delivering high-quality healthcare and ensuring that service users are protected from harm. Our study reiterates the importance of the relationship between patient experience and patient safety, highlighting that providers should align strategies aimed at improving elements of patient experience to broader safety and quality efforts, because progress in one area can help drive improvements in the other.
Every year we celebrate examples of best practice at our Picker Experience Network (PEN) Awards. This year, in partnership with Patient Safety Learning, we have a “Patient involvement in safety” award that recognises patients who have worked with healthcare providers to drive meaningful safety improvements. Six finalists have been shortlisted for this category, with the winner to be announced on 1 October at our award ceremony in Birmingham.
The best improvements happen when patients and service users are actively involved in co-producing strategies to avoid harm and improve experience – this adopts a “do with” approach, focused on the things that are most important to them. The government’s Ten Year Plan for Health is clear that a shift from hospital to community is central to its plans for NHS reform, alongside an ambition to give power to patients. Only by listening to and acting on concerns raised by people accessing and using services can we deliver a safe, effective and truly person-centred NHS.
