There are some lessons in health care that stay with you because you have not only studied them or discussed them professionally but have experienced them yourself. I know this from personal experience. Having been a patient who developed an infection following medical care, I have a very different appreciation of what patient safety means. As health care professionals, we tend to think in terms of diagnoses, procedures, protocols and outcomes. For a patient, however, safety is more basic. It is the expectation that the treatment intended to make them better will not expose them to avoidable harm.
This is why World Patient Safety Day is more than an annual observance. The 2026 theme, “Safe care for noncommunicable diseases”, with the slogan “Safe care for life!”, asks us to look at safety across the entire care journey. For a person living with diabetes, hypertension, cardiovascular disease, cancer or chronic respiratory disease, that journey may continue for years or decades. Safety risks can arise during screening, diagnosis, treatment, procedures, medication use, referral, follow-up, rehabilitation and self-care.
This wider frame is important for India. The country has made remarkable progress in expanding health care access and infrastructure. Ayushman Bharat, the Ayushman Bharat Digital Mission, medical colleges, AIIMS institutions, district hospitals and advanced diagnostic capabilities have changed the scale and ambition of health care delivery. The next stage of this transformation must be about making that care consistently safe, reliable and accountable. A mature health system is not judged only by the number of hospitals it builds or procedures it performs. It is judged by how systematically it identifies risks, prevents avoidable harm and learns when things go wrong.
In NCD care, harm is not always dramatic. A missed diagnosis, a delay in acting on an abnormal investigation, duplication of medicines, poor medication reconciliation, failure to monitor treatment, an unsafe procedure or loss to follow-up may cause harm slowly and silently. These risks increase when a patient moves between primary care, specialists, diagnostic facilities and hospitals without adequate continuity of information or responsibility.
Health care-associated infections are one part of this larger safety picture. A patient admitted for surgery, intensive care, a diagnostic procedure or treatment may acquire an infection that was not present when they entered the facility. For people with NCDs, particularly those who undergo repeated procedures, cancer treatment, dialysis or prolonged hospital care, repeated exposure can increase vulnerability. Surveillance and infection prevention therefore remain central to patient safety.
The growing use of advanced diagnostics and image-guided interventions offers a useful example. Contrast media are integral to modern imaging and interventional care. They improve visualisation, support diagnosis and help clinicians plan treatment. Their clinical value is well established. But, as with every medical intervention, the benefit must be accompanied by systems that manage risk carefully.
Safe contrast administration begins before the injection. The indication should be appropriate, relevant clinical history and risk factors should be assessed, the correct contrast agent and dose should be used, and staff should be prepared to recognise and manage adverse reactions. Infection prevention is equally important. Pressure injectors, syringes, tubing, connectors and patient lines should be used strictly in accordance with their validated instructions and intended use. Equipment or consumables labelled or validated for single-patient use should not be reused across patients.
The larger lesson is not about one product or one procedure. It is about the safety chain. A sophisticated diagnostic technology is only as safe as the systems surrounding it: Correct patient identification, appropriate clinical assessment, trained staff, aseptic practice, properly maintained equipment, adherence to instructions for use, monitoring during the procedure and timely response if something goes wrong. Small deviations can become important when the same process is repeated thousands of times.
This is where health care systems need to move beyond the assumption that having a protocol is equivalent to implementing it. Hand hygiene, environmental cleaning, catheter management, antimicrobial stewardship, medication safety, equipment handling, diagnostic safety and validated use protocols are parts of the same patient-safety system. A weakness at any point can compromise the entire chain.
Patient safety cannot depend entirely on individual vigilance, however sincere or committed the clinician may be. It must be embedded in systems, processes, training, audits, incident reporting and institutional culture. The aim is not to create more paperwork. It is to make safer practice easier and more reliable practice.
India already has important foundations. Following pilot work in late 2016, a healthcare-associated infection surveillance network was initiated in 2017 by AIIMS New Delhi, with technical coordination by the Indian Council of Medical Research and the National Centre for Disease Control and support from the US Centers for Disease Control and Prevention. The network has generated useful evidence, particularly on bloodstream infections and antimicrobial resistance, but routine surveillance still covers only a limited part of the country’s vast and diverse health care system.
That gap matters because patient care is not confined to large tertiary hospitals. People receive treatment in district hospitals, secondary facilities, nursing homes, cancer centres, diagnostic centres and smaller private institutions. Patient safety should not become a function of geography, institutional size or the resources available to a particular facility.
The answer is not necessarily another policy document. India needs stronger measurement and more consistent implementation. Existing surveillance and quality systems can be used more effectively. Hospital audits and accreditation can place greater emphasis on compliance with core safety practices. Publicly funded health care schemes can progressively include meaningful patient-safety measures within their quality expectations.
The 2026 theme also requires us to look beyond the hospital encounter. A person screened for hypertension or diabetes should not disappear after diagnosis. An abnormal test result should reach someone who is responsible for acting on it. A referral should not become a one-way transfer of responsibility. Medicines should be reviewed, treatment should be monitored and information should follow the patient across levels of care.
Patient engagement is essential, but it should not become a substitute for system responsibility. A person living with several chronic conditions should not have to become the communication link between multiple doctors, laboratories and hospitals. Safe care requires clear responsibility, reliable information flows and continuity over time.
Patient safety conversations must also avoid the temptation to blame individual healthcare professionals. Doctors, nurses, technicians and hospital administrators work in complex environments, often under significant pressure. The objective should not be to create fear around reporting. It should be to build systems in which risks are visible, deviations are identified early and corrective action becomes part of routine practice.
The real measure of progress will be when patient safety becomes almost invisible because it is built into the way healthcare is delivered: when the right medicine, device or consumable is used for the right patient; when infection prevention protocols are followed consistently; when diagnostic and procedural risks are anticipated; when adverse events are reported without hesitation; and when follow-up continues after the patient leaves the facility.
India has the scientific capability, clinical expertise, public health institutions and policy foundations required to make this transition. What is needed now is the discipline to measure more consistently, implement more rigorously and learn more systematically.
On World Patient Safety Day, the message should, therefore, be simple but consequential. Expanding access to healthcare is essential, but access without safety is incomplete progress. For people living with NCDs, safe care cannot be limited to a single encounter. It must extend across diagnosis, treatment, procedures, medicines, transitions and long-term follow-up.
For a patient, safety is not an additional feature of healthcare. It is the foundation of trust. “Safe care for life” should mean exactly that: safe care throughout the entire journey of life.
(The views expressed are personal)
This article is authored by K Madan Gopal, senior health sector expert and former senior consultant, health, NITI Aayog.
