This research provides important new insight into the proportion of people who personally experience harm from NHS care or through a lack of access to care. It highlights striking inequities in the rate of harms in the NHS, with women, patients from lower socio-economic backgrounds, and disabled people disproportionately affected. It is clear that a cultural shift is needed to embed a person centred approach, not just to care, but also when things go wrong.

“The research also shows that data on complaints and from PALS represents the tip of the iceberg. Only around one in eight people who experienced harm contacted PALS, and less than one in five made a complaint. It is concerning that when people do complain, the majority (63%) did not feel that their complaint was handled well. This builds on recent research by Healthwatch England and again demonstrates the need to offer simpler, clearer, and more effective routes by which patients can raise concerns and complain about poor or missing care.

We know that the NHS is under significant pressure, and that public and staff desire for change is high. The upcoming ten-year plan for health and the Dash review of the patient safety landscape provide an opportunity to drive reform and wider cultural change, centred around diverse patient voices. Collecting robust data and learning from experiences of patient-reported harms are essential to creating an effective improvement culture and understanding the impact of changes on population level outcomes.