The NHS reports around 2.4 million patient safety incidents annually, most of which (70%) cause no harm to patients, but around 0.5% of patient safety incidents result in severe harm or death. The 2025 Dash review identified considerable overlap and duplication in the current patient safety landscape with relatively little improvement over the last five to 10 years.12 The Department told us it had set out a new plan to oversee quality and safety as part of the 10-Year Health Plan,13 but did not outline any of the specific measures it will take to achieve this.14 In 2025 the Department announced the planned abolition of NHS England and the Health Services Safety Investigations Body.15 NHS England told us that there is a lot of change going on and it is working to rationalise the patient safety system but that it must take a cautious approach to ensure important functions are not lost.16 The NHS is being asked to find at least £1 billion in savings over the next three years. The ambition is to reduce central staff numbers by up to 50% across the Department, NHS England and Integrated Care Boards by March 2028 and is expected to cost between £1 billion and £1.3 billion.17