NHS England’s March 2026 Integrated Performance Report highlights variation across several patient safety indicators, including mortality, CQC safe ratings, staff confidence in raising concerns and infection control metrics.

The report also records improvement in some areas, including stillbirth and neonatal mortality rates, crisis care response and restrictive intervention use in mental health services.

Key Developments

NHS England reported that 11 providers had a higher-than-expected number of deaths in the period 1 November 2024 to 31 October 2025, using the Summary Hospital-level Mortality Indicator. The report noted that five of those providers also had higher-than-expected deaths for the same reporting period in the previous year, and included possible data quality issues for several listed providers.

The March report also showed variation in CQC safe inspection ratings. Of 147 NHS trusts with a safe inspection rating awarded within the preceding two years, 50 trusts were rated good, one was rated outstanding, 94 were rated requires improvement and two were rated inadequate. NHS England stated that approximately two thirds of trusts inspected for safety in the past two years were rated requires improvement or inadequate.

The NHS Staff Survey raising-concerns sub-score also fell. NHS England reported a national average score of 6.37 out of 10 in 2025, down from 6.45 in 2024. The report states that this signals a gradual downward trend in staff confidence to raise concerns about unsafe clinical practice or believe that action would be taken.

Infection control indicators were mixed. Healthcare-associated C. difficile infections stood at 816 in January 2026, up from 742 in December 2025, but down from 974 in January 2025. Healthcare-associated E. coli infections were 1,153 in January 2026, down from 1,191 in December 2025 and 1,192 in January 2025. Healthcare-associated MRSA infections were 59 in January 2026, up from 24 in December 2025 and 40 in January 2025.

The report also recorded improvement in maternity and neonatal indicators. The stillbirth rate was 3.8 per 1,000 total births in 2024, down from 3.94 in 2023. The neonatal mortality rate was 1.4 per 1,000 live births in 2023, down from 1.47 in 2022.

Mental health safety indicators showed improvement in some areas. Restrictive intervention use was 32 per 1,000 occupied bed days in January 2026, down from 36 in January 2025. Crisis care face-to-face contact within 24 hours reached 67.4% in January 2026, up from 59.5% in January 2025.

Why It Matters

The patient safety data forms part of NHS England’s wider performance reporting across quality, safety, experience, workforce and access. The March report shows that some safety indicators have improved, while others continue to show variation or deterioration.

The reported fall in the raising-concerns score is relevant to safety culture because it measures staff confidence in raising concerns about unsafe clinical practice. NHS England states that, as part of the 10 Year Health Plan, the NHS is implementing measures focused on staff ability and access to raise safety concerns, including effective Freedom to Speak Up functions.

The report also links future improvement to a new Quality Strategy being developed as part of the 10 Year Health Plan. NHS England states that this will include easier-to-understand league tables, stronger board accountability through the “Insightful Provider Board” approach, and regular engagement between national, regional and trust clinical leadership.

The figures provide a published Board-level view of patient safety variation across the NHS. They do not establish clinical negligence, liability or causation, but they identify areas where NHS England is monitoring quality, safety and governance indicators.

Source References

• NHS England, Integrated Performance Report, March 2026.
• NHS England, Meeting of the Board of NHS England – agenda, 26 March 2026.