Date published: 3 August, 2026
Date last updated: 3 August, 2026
Patient safety

Patient safety partners: 2025 survey review and recommendations

1. About this review

This review presents findings from the 2025 national survey on the implementation of patient safety partners (PSPs), in line with the Framework for involving patients in patient safety (IPIPS). It also draws learning from the patient safety partners 2023 survey.

The review:

  • highlights what is working well
  • identifies areas where challenges persist and improvement is needed
  • sets out recommendations for patient safety partners, patient safety leaders, NHS trusts, integrated care boards (ICBs) and NHS England
  • outlines the steps NHS England will take in response to the findings

2. Who should read this?

Patient safety partners, patient safety specialists (who lead on patient safety in NHS organisations), trust leaders and ICB Patient safety specialists will find both learning and recommendations for action relevant to their roles.

The publication signposts to resources hosted on the Futures collaboration platform (you need to log in to access this platform.) throughout. Read more about how to access the Futures collaboration platform.

3. A note to patient safety partners

If you are reading this as a patient safety partner (PSP), your voice has an important place in conversations about patient safety.

You bring experience that cannot be taught and insights that cannot be generated by dashboards. You ask questions that matter precisely because they are sometimes uncomfortable.

Many of you came into this role because something happened – to you, to someone you love or to people you care about – and you chose to turn that experience into action.

The findings in this review highlight 3 important points.

Many patient safety partners share similar experiences. The challenges you may experience – uncertainty about the role, frustration when your views aren’t always heard, and emotional fatigue when dealing with harm – are shared by many others across the NHS.

You bring real value. When PSP roles work well, they change conversations, decisions and culture. Not because PSPs are representative of all patients, but because they help organisations stay connected to the reality of care and harm.

The system has responsibilities too. Sustainable partnerships are not about resilience or goodwill alone. They rely on clarity, fairness, support and commitment from leadership.

We hope this review helps you feel seen, equips you to ask informed questions and strengthens the case for PSP roles that are credible, supported and genuinely influential.

4. About the 2025 survey

4.1 Who responded?

Responses were received from 118 patient safety specialists (PSSs) and 49 patient safety partners (PSPs), representing 136 organisations across acute, mental health, community, specialist trusts, ambulance trusts, ICBs and NHS England regions.

4.2 How was the survey conducted?

The PSS survey ran from May to July 2025, and the PSP survey ran from June to September 2025. Questions were adapted for each audience, and additional questions were included in the PSP survey.

4.3 How representative are the findings?

There are approximately 800 registered PSSs and an estimated 1,000 plus (though unvalidated) number of PSPs nationally.

Since April 2026, the NHS Standard Contract has required NHS trusts and foundation trusts to have 2 or more PSPs in place. As of mid-2025, The King’s Fund reported there were 202 trusts in England, including acute, mental health, specialist and community trusts, as well as 10 ambulance trusts.

With responses from 136 organisations, spanning a wide range of settings, the survey provides a substantial snapshot of current PSP implementation across the NHS.

5. Recommendations

The survey findings show that effective relationships are fundamental to the successful implementation of patient safety partners. Structures, frameworks and contracting matter – but what sustains impact is trust, clarity, respect and support.

Where organisations invest in these qualities, PSPs can successfully contribute to learning, culture and safer care, supporting the NHS England » The NHS Patient Safety Strategy

5.1 For PSPs

5.2 For PSSs, patient safety leaders and organisations

5.3 For ICBs

  • Confirm with NHS providers in your area that each organisation has 2 or more PSPs,  in line with the NHS Standard Contract. Where this is not the case, follow up directly with the relevant trust.
  • Use the FAQs (Futures collaboration platform)and send feedback to patientsafety.enquiries@nhs.net

6. Findings: 2025 survey headlines

Of the organisations that responded, the data showed:

  • 63% of organisations have 2 or more PSPs, compared to 36% in 2023
  • 51% pay involvement payments to PSPs, compared to 56% in 2023
  • PSPs spend an average of 18 hours per month on the role
  • PSPs reported that close working with staff, a sense of belonging and regular check-ins help them stay in the role
  • PSSs reported that approaching existing volunteers was the most effective recruitment method, but there were challenges with identifying training and funding and clearly defining the PSP role
  • The most common reasons PSPs left the role were:
  • lack of role clarity
  • uncertainty about expectations
  • payments not being in place
  • time commitment
  • The 3 most common areas for patient involvement in safety programmes were:

7. Findings: what patient safety partners told us about their experience

PSPs are vital for putting into practice a long-standing principle outlined in the 2013 report of the National Advisory Group on the Safety of Patients in England:

“Patients and their carers should be present, powerful and involved at all levels of healthcare organisations from wards to the boards of trusts.”

Survey responses suggest PSPs are motivated by much more than contractual obligation. 3 strong themes emerged from the survey:

  • motivation
  • feeling valued
  • psychological safety

7.1 Motivation is based on experience and care for others

Many PSPs entered the role following experiences of harm, loss or distress in healthcare, either as patients or carers. Others brought long-standing experience from community, advocacy or professional roles.

Common threads include:

  • a desire to prevent harm happening to others
  • a need to make sense of difficult experiences by contributing to improvement
  • strong values around fairness, compassion and speaking up

As one PSP said:

“I want to ensure that experiences I have had don’t happen to someone else.”

Another reflected:

“This role gave me permission to put aside my long-standing fear of ‘rocking the boat’, and share knowledge and guidance objectively, for the sake of those who may not feel confident or have the privilege to speak directly – but whose voice deserves some amplification.”

PSPs often described the role as a way to “give something back”, while also helping to keep patient perspectives at the centre of safety conversations that may otherwise become procedural, transactional or technical.

7.2 Feeling valued matters more than structures

PSPs who feel welcomed, listened to and taken seriously report high satisfaction – even when time is limited or systems aren’t perfect.

Feeling valued is often created through personal relationships with patient safety or experience leads, or PSSs, in their host NHS organisation. PSPs described the importance of being involved early in discussions and being told how their input influenced decisions or actions.

One PSP said:

“The staff are generally very supportive too and find our input valuable and tell us that, particularly the senior team.”

Conversely, PSPs who felt their involvement was a “tick-box exercise” described frustration and disengagement, and in a couple of cases chose to leave the role.

As one respondent explained:

“I was full of hope and enthusiasm when I was recruited, but sadly, there seems to be little commitment in the organisation to using our skills and hearing what patients have to say.”

7.3 Psychological safety

PSPs are most effective when they feel able to speak up, raise queries, report mistakes, and propose new ideas without fear of punishment or humiliation.

Respondents valued environments where they could admit when they didn’t understand jargon or processes and could ask difficult questions without embarrassment or defensiveness from staff. PSPs also wanted their perspectives to be treated as a legitimate source of insight rather than dismissed as “anecdotal”.

As one PSP reflected:

“I felt enabled to be my authentic self and be honest about my lived experience.”

Where leaders explicitly model openness and curiosity, PSPs are more confident acting as constructive critical friends rather than observers.

8. Findings: what helps patient safety partner roles succeed

Despite variation between organisations, PSPs consistently identified several factors that helped them succeed in the role.

8.1 Strong onboarding and induction

PSPs valued clear explanations of the role before appointment, including honest conversations about expectations and limitations. They also need time to understand patient safety concepts – including PSIRF and Martha’s Rule – without being overwhelmed.

Good practice examples included buddying with another PSP or patient safety specialist (PSS), pre-meeting briefings and opportunities to ask questions privately and check understanding in a supportive environment.

As one PSP explained:

“I have been well supported so far, but it can seem quite daunting when faced with all the data, training, frameworks, jargon and lots of meetings to attend when it’s all so new to me.”

Another commented:

“Having a buddy system in place works really well, ensuring that PSPs have a named person to provide support.”

See the recommendations section for what organisations should do to strengthen onboarding.

Further resources

Information on diverse recruitment, onboarding and induction is available on the Future collaboration platform (login required):

8.2 A named contact and regular support

PSPs reported that the most positive experiences involve named, consistent points of contact, such as a dedicated patient safety or experience lead or PSS.

PSPs valued regular one-to-one check-ins or reflection conversations, plus informal contact via email, Teams or WhatsApp for quick questions. These relationships help PSPs feel part of a team rather than an add-on.

One PSP commented:

“In order to be effective, PSPs need to answer to at the very least the head of patient safety.”

Further resources

Information on regular support for PSPs is available on the Future collaboration platform (login required):

8.2 Psychological safety

PSPs reported that the most positive experiences involve named, consistent points of contact, such as a dedicated patient safety or experience lead or PSS.

PSPs valued regular one-to-one check-ins or reflection conversations, plus informal contact via email, Teams or WhatsApp for quick questions. These relationships help PSPs feel part of a team rather than an add-on.

One PSP commented:

“In order to be effective, PSPs need to answer to at the very least the head of patient safety.”

Further resources

Information on regular support for PSPs is available on the Future collaboration platform (login required):

8.3 Being embedded, not brought in at the end

PSPs wanted to know their roles are making a difference.

Respondents described the greatest impact when PSPs were involved early in discussions and decision-making, rather than being asked to comment once plans had already been developed.

Examples included involvement in:

  • safety or governance committees
  • PSIRF planning and learning responses
  • staff training
  • safety walk-rounds and huddles
  • patient information work

As respondents explained:

“I want to be in a position to influence and contribute to this work in my local trust.”

“It is important to ensure PSPs are involved from the start of discussions, not only at the end, so patients’ perspectives shape safety improvements in a meaningful way.”

“We can hold empathy at the forefront of our work, and not be afraid or intimidated by any institutional hierarchies within the NHS that are not serving our service users.”

Further resources

8.4 Valuing different strengths and perspectives

Good practice recognises that people contribute in different ways.

Some PSPs excel in strategic discussion and governance, while others connect more strongly with patients on wards or in communities.

PSPs often bring professional expertise to the role – for example, through previous experience in healthcare, social services or education. PSPs are also members of local communities, enabling them to offer a wider perspective and advocate more broadly.

Respondents emphasised the importance of recognising and supporting these different strengths while still ensuring contributions support safety priorities.

As PSPs observed:

“More diversity (beyond retired white people) would bring wider insights and scope for reaching a wider patient demographic.”

“Thinking about the individuals’ strengths and making sure they are supported to make their voice count.”

Further resources

Information on PSP mentors is available on the Future collaboration platform (login required):

9. Findings: recurring challenges

Alongside examples of good practice, the survey revealed some recurring challenges that can limit the effectiveness and sustainability of PSP roles. 

Respondents highlighted the importance of:

  • consistent payment
  • clear role design
  • emotional support
  • visible leadership sponsorship 

Some of the challenges PSPs faced are described in the following blogs:

9.1 Lack of role clarity causes frustration

Lack of clarity about the PSP role was one of the most frequently reported sources of frustration.

PSPs described receiving inconsistent expectations from different staff within organisations and confusion between “PSP”, “patient voice” and other involvement roles.

Respondents wanted clarity about what is expected – and what is not. Lack of clarity leaves some PSPs feeling adrift and disempowered.

As respondents explained:

“I was involved with none of the patient safety initiatives to my complete frustration.”

“I would consider leaving if I felt that patients’ voices were not being listened to or valued in decision-making, or if there was no meaningful opportunity to influence safety improvements.”

See the recommendations section for what organisations and NHS England should do to help address this.

Further resources

9.2 Payment, expenses, and fairness affect trust

The survey highlighted a considerable variation in how PSPs are reimbursed for their time and expenses. Arrangements ranged from unpaid voluntary roles and expenses-only models to involvement payments, bank roles or Agenda for Change banded roles.

Respondents viewed payment not only as a practical issue but also as a signal of how their contribution is valued, which created strong feelings within and between organisations about fairness and respect.

A small number of PSPs reported they had been promised remuneration that had not yet been received, damaging goodwill and sometimes resulting in the PSP leaving the role.

Without consistent payment, barriers are created for people such as those from lower-incomes, and those with caring responsibilities, meaning diverse experiences and voices are lost. PSPs need to be able to participate without financial loss or personal harm.

As respondents put it:

“Feeling like the pay is unfair in relation to everyone else who is always around the same tables as me.”

“When I was recruited, involvement payment was mentioned but it hasn’t been instigated.”

See the recommendations section for actions organisations should take.

Further resources

9.3 Emotional burden is not always recognised

A couple of PSPs described exposure to distressing information about harm without sufficient psychological support, particularly when working in mental health and community contexts.

One respondent commented:

“Overwhelming levels of incidents (or examples of very poor practice) can be very difficult to be constantly exposed to without psychological support.”

Without access to supervision, peer support or opportunities to reflect, PSPs can experience emotional fatigue and may find it difficult to continue in the role. PSPs need to know that their time, experience and personal contribution are valued and must be appropriately supported.

When PSPs are not well supported, the role can become distressing and also less effective. NHS England considers PSP wellbeing and safety a priority.

See the recommendations section for what organisations should put in place.

Further resources

9.4 Limited capacity on both sides

Even when there is goodwill, PSPs’ involvement is sometimes constrained by under-resourced patient safety teams and competing organisational priorities.

Staff need sufficient time and organisational backing to properly support PSPs, with clear permission to invest in relationships – not just outputs.

As one PSP explained:

“I was recruited 2 years ago when PSIRF was being implemented, and nothing really happened for the first 6 months.”

10. Priorities for effective patient safety partner involvement

The survey findings highlight 5 priorities to ensure successful PSP involvement.

10.1 Clear role definition

  • Develop clearer national role principles and boundaries.
  • Allow local flexibility to reflect context, but avoid “anything and everything” expectations.
  • Distinguish PSPs from broader patient voice roles while supporting the connection between them.

10.2 Leadership and support

  • Ensure PSPs have access to senior, influential leaders.
  • Build PSP support into staff job planning and capacity.
  • Normalise pre-briefing, de-briefing and reflective conversations with PSPs.

10.3 Safe, supported spaces for challenge

  • Model respectful challenge in meetings.
  • Actively invite PSP perspectives rather than waiting for them to speak.
  • Close feedback loops so PSPs can see their impact.

10.4 Equity and inclusion

  • Tackle payment and expenses inconsistencies transparently.
  • Design PSP roles so they can be undertaken by a range of people, including people who are employed, students, carers or those who need financial recompense.
  • Work with community organisations to broaden recruitment.

10.5 Emotional support and wellbeing

  • Offer supervision, peer networks and wellbeing support.
  • Acknowledge exposure to harm as part of the role.
  • Build in time for reflection and recovery, not just task delivery.

11. Learning and actions for NHS England

  • By autumn 2026, highlight to trust leadership and patient safety teams the decline in involvement payment rates (from 56% in 2023 to 51% in 2025) and reaffirm that payment is expected and supports inclusion.
  • Publish an updated PSP role description by autumn 2026, including co-designed updates for mental health and primary care organisations.
  • Host a national webinar for PSPs by autumn 2026, presenting key survey findings and providing a space for PSPs to ask questions and share experiences.
  • Present the findings and recommendations in this review at a national PSS webinar in autumn 2026.
  • Co-create a presentation about the role of PSPs and how PSPs can ask good questions, for sharing and local adaptation by autumn 2026 (to be made available on Futures collaboration platform).
  • Share this review across NHS England communications channels.

12. Accessing NHS England’s Future collaboration platform

Several resources referenced in this document are hosted on NHS England’s Future collaboration platform.

You can self-register using an nhs.net, nhs.uk or gov.uk email address.

If you have a different email address – including if you are a PSP without an NHS email – please contact patientsafety.enquiries@nhs.net and the team will invite you to the Support for Implementing the Framework for Involving Patients in Patient Safety (IPIPS) workspace.

Publication reference: PRN02491

Date published: 3 August, 2026
Date last updated: 3 August, 2026