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thumbnail of Quality versus safety in healthcare – a national debate f

Author
Nick Woodier, Jonathan Back, Deinniol Owens, Helen Vosper, Paul Bowie
Abstract
A 2025 review of the patient safety landscape in England described that the National Health Service’s focus on safety has been at the detriment of other aspects of quality of care, such as effectiveness. Concerns have been raised that the review will lead to de-prioritisation of patient safety due to a fundamental misunderstanding of safety science. This paper provides an overview of an exploratory study of 1) perceptions around quality and safety in healthcare, and 2) evidence of trade-offs seen in national safety investigations. The paper concludes that safety should be considered as the foundation for quality, rather than as a dimension of quality. It recommends 1) a fundamental rethink about how the NHS views and prioritises patient safety, and 2) the need for healthcare to employ evidence-based safety and risk management principles.