The NHS is forced to spend a “staggering” £14.7bn a year treating people who have been harmed by mistakes made during their care, a report reveals.
And a stark north/south divide on patient safety has opened up across England, with double the amount of death and disability caused by medical negligence in the north-east than in London.
The report, by experts at Imperial College London, found that the safety of the care patients receive had declined over the past two years, with errors leading to 820 preventable deaths a year.
The authors include Prof Lord Ara Darzi, the surgeon and former health minister who produced a major NHS report for the Labour government, which highlighted avoidable patient deaths.
Darzi said there had been “alarming declines” in 12 key metrics of patient safety in England since 2022. They include maternity care, in which there are growing rates of stillbirth, babies dying during or soon after they are born and also women dying while giving birth.
“Our analysis highlights a troubling increase in neonatal and maternal deaths, with Black women disproportionately affected,” said Darzi, the co-director of Imperial’s Institute of Global Health Innovation, which drew up the report.
He urged ministers and NHS bosses to take “immediate action” to improve maternity care. The Royal College of Midwives said staff shortages, including of specialist midwives, were a key reason for the recent deterioration in women’s experiences during pregnancy, labour and afterwards – a decline which reviews by other organisations have also identified.
The report, commissioned by the charity Patient Safety Watch, also found that:
There is a widening gap between the performance of the NHS compared with that of the best-performing OECD countries on deaths from treatable causes, such as sepsis and blood clots.
If the NHS did as well as the top 10% of OECD nations, there would be 13,495 fewer preventable deaths every year – compared with the 12,675 there are in England.
Rates of the hospital superbug Clostridium difficile (C diff) rose by 54% between 2018-19 and 2023-24.
Compared with the rest of England, the north has the highest proportion of NHS trusts at which a greater-than-expected number of patient deaths occur, the Imperial team said. The proportion of trusts in the north where such fatalities occur has risen from 8% two years ago to 14% – one in seven.
In addition, rates of what they call “the adverse effects of medical treatment” – death and disability caused by a procedure or other care – are twice as high in the north-east than in London.
Paul Whiteing, the chief executive of patient safety charity Action against Medical Accidents (AvMA), said: “This report shows the staggering costs involved in having to treat patients who are harmed through medical harm. That, together with the wide regional disparities in avoidable harm, should mean that the main focus of the government’s promised 10-year NHS plan, which is expected next May, should be on ramping up patient safety.
Rebecca Hilsenrath, the acting NHS ombudsman, said: “I am still seeing a rise in investigations about maternity care, which suggests that despite considerable investment and reviews into service failings, things are far from improving.
“There have been successive inquiries and reports into maternity care and sadly no real change. The safety and wellbeing of women is being put at risk due to the same mistakes being made.”
But, she added a “defensive NHS leadership and culture sadly surfacing time and time again in our own investigations” suggests that NHS bosses do not take lessons onboard when errors occur.
She urged ministers to drive through “a cultural shift” in the service’s attitudes to mistakes. “We need an NHS that prioritises accountability, transparency and patient-centred care and which listens to and welcomes patients’ concerns as a resource for learning rather than as a reputational threat,” she said.
NHS England declined to comment on the report’s main findings. A spokesperson said: “NHS staff are working exceptionally hard to deliver safe patient care, and we are focused on ensuring every part of the health service is working together to manage demand and prioritise patients with the most urgent needs this winter.”
