Written Statements

Monday 7th July 2025 Written Statements

Monday 7 July 2025

Report on Patient Safety

Monday 7th July 2025 Written Statements

[The Secretary of State for Health and Social Care (Wes Streeting)]

I would like to update the House on Dr Penny Dash’s report on patient safety across the health and care landscape in England.

In September, Dr Dash completed her review of the Care Quality Commission. Her work was thoughtful and thorough, and shed a huge amount of light on how the principal regulator for quality and safety had been letting people down. The CQC is now under new management, and on a clear path to recovery.

Following this important work, I asked Dr Dash to undertake a further review—this time looking at six key organisations overseen by the Department of Health and Social Care and how they work with the wider patient safety landscape. Today, we are publishing this review, and I am grateful to Dr Dash for her work.

Her review focused on the Care Quality Commission, the National Guardian’s Office, Healthwatch England, the Patient Safety Commissioner, the Health Services Safety Investigations Body and the patient safety learning aspects of NHS Resolution. I asked her to assess whether the current range and combination of organisations delivers effective leadership, listening, learning and regulation of health and care systems in relation to patient safety.

She specifically addressed whether patients would be better served by a different approach or delivery model, working closely with senior leaders and directly hearing from more than 100 people or partner organisations with an interest in patient safety.

She found that there has been a shift towards safety—in comparison with other areas of quality of care—over the last five to 10 years, with too much focus on inputs and structures, rather than outcomes for patients. She also found there has been limited strategic thinking on improving quality of care during this period.

The review sets out how many organisations are carrying out reviews and investigations, leading to an overwhelming number of recommendations. This causes confusion for patients and staff alike. At the same time, patient experience is not given the attention it deserves in the NHS, with few boards having an executive director dedicated to this purpose.

As a result of this analysis, Dr Dash has made nine recommendations, which the Government have accepted in full. These commitments form an important component of our 10-year plan for health, published last week.

First, there should be a refreshed strategy for improving quality of care, which will be delivered by revamping and revitalising the role of the National Quality Board.

Secondly, the Care Quality Commission should continue to rebuild with a clear remit and responsibility and overhaul its registration and inspection processes to ensure they are “sector specific”.

Thirdly, the Health Services Safety Investigations Body should continue as a centre of excellence for investigations, but as a discrete branch within the Care Quality Commission.

Fourthly, the hosting of Patient Safety Commissioner should transfer to the Medicines and Healthcare products Regulatory Agency (MHRA) to strengthen links between the patient voice in medicines safety and the MHRA’s work to capture adverse events more effectively. The Patient Safety Commissioner’s work on wider patient safety should transfer into a new directorate of patient experience in DHSC.

Fifthly, local healthwatch and the engagement functions of integrated care boards (for healthcare) and local authorities (for social care) should be brought together to ensure patient and community input into the planning and design of services, and the strategic functions of Healthwatch England should also be transferred into the new patient experience directorate in DHSC.

Sixthly, staff voice functions should be strengthened, with the responsibilities of the National Guardian for Freedom to Speak Up incorporated into the new DHSC structure and providers.

Seventhly, the responsibility for and accountability of commissioners and providers to deliver and assure high quality care should be reinforced.

Eighthly, technology, data and analytics should play a much more significant role in supporting the quality of health and social care.

Finally, there should be an evidence-based national strategy for quality in social care.

Next steps

I previously announced that Dr Dash would undertake a third review on quality and its governance. However, this work has been fully incorporated as part of the 10-year health plan, and we are taking this forward with immediate effect.

Patient and staff voice should not be kept at arm’s length but be at the heart of everything the NHS does. As part of the plan, we are therefore streamlining and consolidating functions across the patient safety landscape, delivering a refreshed strategy for improving the quality of care and transforming how the NHS collects and uses patient feedback.

These changes will improve quality, including safety, by making it clear where responsibility and accountability sit at all levels of the system, and making it easier for staff, patients and users to directly feed into the system to improve quality of care.

[HCWS785]

Internal Drainage Board Levy Support Grant

Monday 7th July 2025 Written Statements

[The Minister for Local Government and English Devolution (Jim McMahon)]

Following the local government finance settlement on 3 February 2025, the Government confirmed a £5 million grant to support local authorities facing significant increases in special levies from internal drainage boards. This represents a £2 million uplift from the originally announced £3 million, reflecting the Government’s recognition of the continued financial pressures on local authorities affected by these special levies. Services provided by internal drainage boards are energy-intensive and have been particularly impacted by rising energy costs and adverse weather conditions over the past three years.

Today I am confirming the allocation of this funding to the 18 local authorities most severely affected. Councils and internal drainage boards are encouraged to continue to work together to deliver services efficiently and to ensure good value for money for the public.

Local Audit Backlog

Monday 7th July 2025 Written Statements

[The Minister for Local Government and English Devolution (Jim McMahon)]

Local audit is the bedrock of local accountability and transparency, and of trust and confidence in councils to spend taxpayer money wisely. But 14 years of neglect took the system to breaking point and damaged a key part of our early warning system over local government finances at the time we need it the most. We are determined to rebuild the foundations of local government so that it is fit, legal and decent. The Government have taken swift and decisive action to clear the backlog of unaudited local authority accounts in England and put the local audit system on a more sustainable footing. This has included setting a series of statutory backstop deadlines for the publication of audited accounts. These proposals were enacted via legislation in autumn 2024, and two backstop deadlines have now passed. This failure of the system has resulted in poor value for money and additional costs, with some £49 million of grant committed to support bodies with the cost of building back assurance in 2024-25 and 2025-26. https://www.gov.uk/government/news/overhaul-of-local-audit-will-restore-trust-in-broken-system

This statement updates on the outcomes of the second backstop on 28 February 2025, confirms publication of the non-compliance list on gov.uk, gives details of the support available to bodies affected by the backstop measures, and updates on the Government’s longer-term plans for reform of the local audit system.

28 February 2025 backstop—for financial year 2023-24

Local bodies, unless exempt, were required to publish their audited accounts for financial year 2023-24 by 28 February 2025. Over 92% of bodies have published audited accounts for financial year 2023-24. Just under 50% of bodies published a disclaimed opinion due to the backstop, while 41% published unmodified—clean—opinions. The 13 bodies were exempt from the publication requirements; however, exemptions no longer apply for three of these bodies, and they have now published their audited accounts. Taken together, the publication figures continue to demonstrate a significant improvement in the overall publication of audited accounts, despite the proximity between the two.

Non-compliance list

I can confirm that the Government have today published a list of bodies that failed to meet the publication requirements at this backstop. The list indicates whether bodies published their draft accounts by 16 January 2025—the latest date on which the 30 working day inspection period could commence for it to conclude by the backstop; whether the audit opinion was delivered by the backstop; the date on which it was delivered; and whether bodies published subsequently audited accounts by 20 May 2025.

All bodies and their auditors included on the list have been contacted, and the Government will continue to engage to ensure that outstanding audited accounts for all outstanding financial years are published as soon as practicable. This includes further engagement with a small number of bodies to better understand their reasons for failing to publish draft accounts sufficiently ahead of February’s backstop and the actions that they are taking to publish audited accounts as soon as practicable to be in a position to comply with future backstops. The release of funds to councils to support bodies with the cost of building back assurance will be contingent on the publication of audited accounts and audit fees being paid.

27 February 2026 backstop—for financial year 2024-25

The deadline for publication of audited accounts for financial year 2024-25 is 27 February 2026. In line with amendments made to the Accounts and Audit Regulations 2015, bodies are required to publish their draft accounts by 30 June 2025. The Government will monitor compliance with this deadline with a view to ensuring improvements to the overall system of compliance and timeliness. The Government continue to consider the appropriate incentives and sanctions for the overhauled local audit system and have already set out that the local audit office, once established, will take on oversight in relation to the quality and timeliness of accounts preparation and publication of audited accounts.

Systemic reform

In December 2024, the Government published their ambitious strategy to overhaul the broken local audit system. This strategy set out a clear purpose for local audit and its users, proposals for simplified and proportionate financial reporting, improvements to the market’s capacity and capability, and ways to build strong relationships between local bodies and auditors. The establishment of a new single body, the local audit office, to oversee local audit will radically simplify and streamline the currently fragmented system. The LAO will be proportionate and focused on local audit matters, ensuring efficiency, transparency and value for money. The Government also published in early April a response to their consultation, which included 16 further commitments to reform the system.

[HCWS784]