What is actually happening on Patient Safety Incidents?

How Many NHS Patients Are Harmed Each Year?

Over 1.5 million patient safety incidents are reported annually — around 11,000 result in severe harm or death — and the NHS spends £2.4 billion per year on clinical negligence claims.

Over 1.5 million patient safety incidents are reported to NHS England each year — around 11,000 of which result in severe harm or death.[1] These figures require careful interpretation: higher reporting rates can indicate a healthier safety culture, where staff feel confident raising concerns, as much as more frequent harm. The NHS's National Reporting and Learning System was explicitly designed to encourage near-miss reporting precisely to identify systemic risk before it causes harm.

Clinical negligence costs have grown from £0.86 billion in 2010 to £2.4 billion in 2023/24.[2] Maternity claims account for the largest category — roughly 60% of total cost despite being a small share of NHS activity. The Ockenden Review (2022) found systematic failures at Shrewsbury and Telford NHS Trust spanning two decades, resulting in avoidable deaths and brain injuries among hundreds of babies and mothers.[3] Similar patterns emerged from the East Kent and Morecambe Bay reviews.

The burden of unsafe care falls disproportionately on those least able to advocate for themselves. Patients in maternity services, mental health inpatient units, and emergency departments account for a disproportionate share of serious incidents.[1] Rising clinical negligence costs also represent a significant and growing pressure on NHS budgets — money spent on legal claims and settlements that cannot be spent on care.[2]

NHS patient safety incidents reported, England, 2015–2024 (millions)

Total patient safety incidents reported to the National Reporting and Learning System (NRLS) and Patient Safety Incident Management System (PSIMS). Rising reporting can reflect both improving safety culture and deteriorating care.

Source: NHS England, National Reporting and Learning System / PSIMS, 2024, Updated annual

NHS clinical negligence costs, England, 2010–2024 (£bn)

Annual expenditure on clinical negligence claims, including settlements, legal costs, and provisions. Managed by NHS Resolution.

Source: NHS Resolution, Annual Report and Accounts, 2024, Updated annual

  1. [1]NHS EnglandPatient Safety Incident Management System (PSIMS), 2024
  2. [2]NHS ResolutionAnnual Report and Accounts, 2023/24
  3. [3]Donna OckendenIndependent Review of Maternity Services at Shrewsbury and Telford NHS Trust, March 2022

Sources & Methodology

NHS England — Patient Safety Incident Management System (PSIMS). Published annually.

NHS Resolution — Annual Report and Accounts. Clinical negligence costs include all NHSLA-managed claims, settlements, provisions, and legal costs.

Donna Ockenden — Independent Review of Maternity Services at Shrewsbury and Telford NHS Trust. March 2022. Never events are defined under the NHS England Never Events Policy and Framework.

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