Dr Penny Dash’s comprehensive review of patient safety in healthcare has generated significant discussion among medical professionals. Released in July 2025, this key assessment examines the various organisations responsible for ensuring safety within the NHS, particularly as medical negligence cases continue to highlight systemic issues. This analysis explores the review’s main findings and recommendations for improving care quality.
The review evaluates six major organisations, including the Care Quality Commission (CQC), Health Services Safety Investigation Body (HSSIB), and the Patient Safety Commissioner, noting concerning overlaps in their roles. Despite investing over £160 million in safety initiatives over 10 years, improvements have been limited.
Current patient safety The NHS safety framework has evolved in response to major care failures, typically leading to new oversight bodies after public inquiries. This has created a fragmented system with multiple organisations focusing on safety and quality.
The NHS handles about 3,000 safety investigations from 600 million patient interactions yearly. Research shows that matching top OECD countries’ standards could prevent 780 deaths annually from unsafe care. In 2022, preventable conditions caused 65% of roughly 82,000 avoidable deaths in England and Wales.
Key findings from the Dash Review
The review identified 10 critical issues within the current safety approach. Despite significant investment, improvements have been minimal, with life expectancy below pre-COVID levels and rising obesity rates.
Patient experience remains a key concern. Most NHS boards lack dedicated user experience directors, unlike other consumer-focused sectors. The complaints system is often confusing and slow to respond, hindering timely solutions for patients.
Key organisations like HSSIB, Patient Safety Commissioner, and CQC have expanded beyond their original roles, adding complexity to the system. The National Guardian’s Office often duplicates providers’ work, affecting whistleblowing efficiency.
While the NHS has extensive data, it’s not fully utilised for improvements. Social care lacks a national quality strategy, with gaps in outcome tracking and quality metrics.
Core recommendations for transformation
The review suggests nine key changes:
1. Revive the National Quality Board
2. Rebuild and refocus the CQC
3. Maintain HSSIB’s investigation excellence
4. Move Patient Safety Commissioner to Healthcare Regulatory Agency
5. Merge Local Healthwatch into ICBs
6. Streamline whistleblowing processes
7. Strengthen safety accountability
8. Use data and AI for safety insights
9. Create a social care quality strategy
Industry response to the Dash Review
The NHS Confederation’s Chief Executive Matthew Taylor welcomed the review’s focus on patient empowerment and local accountability, emphasising the importance of patient feedback channels.
While supporting efforts to reduce duplication, Taylor stressed the importance of maintaining oversight bodies’ core functions and ensuring proper support for local systems, particularly after Healthwatch closures.
David Hare from the Independent Healthcare Providers Network welcomed the recommendations, particularly highlighting the National Quality Board’s revival as a key driver for system-wide improvements.
Implications for Medical Negligence prevention
- The Dash Review’s recommendations could significantly impact medical negligence prevention in the NHS. Streamlined oversight and clearer accountability could help identify safety issues earlier and implement solutions faster.
- Better data use could help spot potential safety concerns before harm occurs. Improved complaint handling and provider accountability could prevent issues from escalating to negligence claims.
- Patient engagement, known to reduce preventable harm, is strengthened through consolidated patient voice functions informing service design.
The Dash review outlines a transformation plan for NHS patient safety, addressing current system fragmentation. The government’s adoption of these recommendations within the 10-Year Health Plan marks a significant shift in safety approach.
Success will depend on effective implementation, measured through reduced preventable harm and improved patient outcomes.
