Major Shake-Up Of Patient Safety Bodies

The effects, NHS App new role and pivotal patient engagement

The NHS 10-Year Plan and the launch of the Review of patient safety across the health and care landscape propose a significant shake-up of existing patient safety bodies. Recommendations include the consolidation or abolition of more than 200 health regulatory agencies and bodies representing patients, and for the NHS App to become the main Trustpilot-like complaints/feedback mechanism. Here we look at the impact on both patients and providers.

With the NHS App in such a pivotal role, we ask how it will meet its new challenge, and how patient engagement is critical to the success of all these strategies.

The Patient Safety Review

In the Review we see the emergence of the National Quality Board as a key player for strategic oversight, and recommendations that aim to fill the gaps and reduce the overlaps between the multiple agencies involved. The Review focuses on six national agencies and the wider safety system, which includes 70+ organisations. The six include:

1. CQC

2. National Guardian’s Office

3. Health Services Safety Investigations Body (HSSIB)

4. Healthwatch England and local Healthwatch

5. Patient Safety Commissioner

6. NHS Resolution

5 Core Problems Identified

According to the report, of around 600 million patient interactions with the NHS each year around 1 in 200,000 results in a safety investigation. If the UK had performed at the top 10% level of OECD countries, there would have been 780 fewer deaths. So, there is room for improvement. Core problems:-

• A need for a strategic approach to improvement and quality of care (including safety) – leading to allocation of resources and prioritisation of recommendations to providers

• Reduction in duplication and overlap of services – specifically around patient and community engagement.

• Too many functions sit outside of commissioners and providers limiting the impact of reviews and inquiries. Many recommendations vary in quality and lack of data and have no cost-benefit analysis

• Need for greater focus on building skills, effective governance and clear accountability for quality and safety within commissioners and providers

• CQC needs to rebuild public, professional and political confidence as an independent body

A Summary Of The Recommendations

A revitalisation of the National Quality Board (NQB)

Too many organisations currently conduct reviews and investigations delivering a confusing number of recommendations at both local and national level – most of which lack a clear delivery mechanism or any cost-benefit analysis.

NQB is to:

• Develop a vision and national strategy to improve quality of care

• Agree national metrics on what good looks like

• Prioritise recommendations

• Improve use of data

• Establish data metrics for social care

Rebuilding the CQC as the lead regulator

• Board governance and accountability to be the key focus

• Assessments to cover five quality domains

• Clarify how risks are identified and managed

Consolidation of services

• Health Services Safety Investigations Body (HSSIB) functions transferred to CQC

• Patient Safety Commissioner functions (medical device safety) to be hosted by MHRA

• Local Healthwatch work to be integrated with ICBs

• Healthwatch to be integrated into DHSC

• NHS Resolution role (negligence claims) to continue as before

• National Guardian’s Office: Freedom for staff to speak up – to be embedded with providers and commissioners

The New Feedback Role of the NHS App – and Its Development

With complaints continuing to rise year on year, and with more than 20 different organisations currently offering routes for patient feedback on care quality, the complaints system is confusing and lacks responsiveness – the review finds. The user voice is fragmented, and complaints are often not handled within the six-month statutory period.  

The proposal to use the NHS App as a primary feedback mechanism represents a significant shift toward digital-first patient engagement – if it can be reengineered to support interactions from the 56 million potential users in England. To meet this challenge, the Tony Blair Institute argues the NHS app should be consumer focused and ‘resemble Uber and Deliveroo’, in its accessibility and supportive infrastructure.

In their new Report, the Institute states the development of the NHS app should be a national priority. They outline it should fully integrate with the proposed Single Patient Record (SPR) and could enable entirely new digital pathways of care, allowing people to diagnose, refer, treat and discharge themselves from digital services.

But The Same Interoperability Challenges Abound

For any patient portal to be successful it must be able to integrate with the disparate legacy systems prolific throughout the NHS – if it’s to give patients complete information. And, although digital channels now account for the majority of patient communications through the NHS App, SMS and email, achieving a consistent, fully ‘digital-by-default’ approach across all services remains a huge uphill challenge.

The NHS App does currently provide a digital front door but only to limited services. And whilst the development of the App to provide fully integrated care pathways is possible, it is not currently in the development plan. Integrating with wearables is, but not until 2035.

The Report warns, ‘Without integration into clinical workflows, even sophisticated tools become expensive irrelevances that clinicians ignore and patients abandon.’

Advanced Patient Portals – A Market Perspective

From a market perspective, the NHS App's evolution creates opportunities for existing healthcare technology providers. Several companies have already developed solutions that address the interoperability and integration challenges identified in the reviews, while ensuring these platforms meet the rigorous patient safety and clinical governance standards.

For example, Wellola's Portasana® platform demonstrates how advanced patient portals can integrate with the NHS App while providing digital care pathways and wearables connectivity. The platform employs open FHIR standards for connectivity with legacy systems and modern devices, enabling real-time clinical insights and patient engagement across care settings.

Such platforms are designed to enhance digital engagement and support self-care management, though independent evaluation data on outcomes like reduced waiting lists would strengthen these claims.

With care moving from sickness to prevention, Wellola is designed to helps patients stay engaged, informed and proactive about their health, reducing the need for reactive interventions later. Wellola builds all of this with the highest standards of security, interoperability and clinical safety.

The broader lesson is that while policymakers debate the NHS App's future development, existing market solutions could accelerate implementation of the digital transformation goals outlined in both reviews.

Declaration of interest: Dr Imran Khan holds regional and national roles in clinical informatics and digital health, including Clinical Digital Lead at Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board, Primary Care Clinical Informatician at NHS National Services Scotland, Chair of the RCGP Health Informatics Group, and Co-Chair of the Joint GP IT Committee. Dr Khan is also Clinical Safety Officer of Wellola. The views expressed in this article are those of the author and Wellola, and do not represent the views of any NHS organizations or professional bodies with which the author is affiliated.