The Harmed Patient Pathway

A Harmed Patient Pathway been developed by Action against Medical Accidents (AvMA) in conjunction with the Harmed Patient Alliance (HPA); they campaigned for change in how healthcare organisations provide care to patients recovering from the trauma of avoidable harm. The final version of the Pathway was published in December 2025, following consultation in late 2024 of over 150 harmed patients, families and professionals. It is a framework that encourages honesty and meaningful compassion in response to the physical and psychological effects that can follow from avoidable harm.

The Pathway has encouraged healthcare providers to prevent and minimise the suffering of harmed patients and families by supporting them after harm has occurred, both physically and in relation to emotional distress. This extends to “second harm” which is caused following an incident of avoidable harm, further compounding the harm.

The framework consists of practical commitments to manage the impact of harm on patients and families correctly. The guidance offered by the Pathway will strengthen “after-harm” practice in the NHS and ensure the experience of harmed patients and families aligns with the commitments of compassionate treatment in patient safety responses.

It is recognised that individuals who have suffered healthcare harm need specific support in order to ensure they are cared for and to reduce the risk of any further harm. The final version of the Pathway sets out six core commitments that should be adhered to by healthcare organisations:

1. Ensuring compassionate and honest communication with harmed patients and their families that supports dignity, trust and just relations.
2. Ensuring that harmed patients and families get the support they need as far as possible and AvMA assist them with access to specialist independent advice and support in order to support wellbeing.
3. To support meaningful involvement of harmed patients and families in investigations or other review processes related to their treatment.
4. To provide harmed patients and families with opportunities to contribute to patient-safety and patient experience improvements in a meaningful way.
5. Harmed patients and families may choose to use external or parallel processes to seek answers and accountability as well as to improve safety for others. AvMA will not allow this to change or needlessly delay engagement with them.
6. Prioritise human wellbeing, trust and just relations in all they do.

There are three core concepts that underpin the six commitments, firstly that a moral duty is owed to patients and their families who have been harmed to do no more harm and support recovery; secondly to recognise the impact that harm would have had on the patient and their family and strive to meet their needs by using the pathway to manage healthcare harm, and finally that meeting the needs of harmed patients and families is an essential part of “just” and “restorative” patient safety culture.

The Pathway is designed to be tailored to the specific circumstances of someone who has been subjected to healthcare harm and not to be used as a checklist, this will ensure that the possibility of enduring secondary harm whether personally or to family members will be reduced.

If your provider adopts the Pathway, you can expect them to meet expectations centred around respect, compassion and supporting those affected by harm in their journey to recovery and to recognise the moral duty to care for those who have been harmed.

The finalisation of the Harmed Patient Pathway is a positive step and is a welcome development. In implementing a comprehensive framework, it will work to uphold a high standard of help to patients and families who have suffered avoidable harm.

It is recognised that unfortunately some avoidable harm cannot be undone, however there should be a duty upon medical staff to facilitate a recovery process to meet harmed patients’ needs as much as possible and reduce the risk of secondary or compounded harm.

Now that the final version of the Pathway has been finalised the next stage is for the NHS to adopt the Pathway formally.

AvMA have recognised that the full across the board implementation of the Pathway may take time due to the current resources of the NHS. Patients and their families deserve the necessary support after suffering harm resulting in the negligence of NHS medical care.