MHRA Alert: Hoist Falls Have Killed Two a Year

MHRA has issued a National Patient Safety Alert covering every type of patient hoist and sling in use across the United Kingdom, ordering hospitals, care homes and home-care providers to complete five safety actions within the next 12 months. The alert, published 16 September 2026, follows a decade-long review that found patients have died from hoist and sling falls at a rate of roughly two a year since 2015 — and traces those deaths to a recurring, largely preventable set of causes rather than to any single faulty product.

A decade of data, not a single incident

National Patient Safety Alerts are MHRA’s highest-profile mechanism for pushing safety action across the whole of UK health and social care at once, rather than through a single manufacturer’s field safety notice. This one was not triggered by one catastrophic failure but by a retrospective review spanning eleven years: 22 reports of a fatal outcome during a hoist or sling transfer between January 2015 and December 2025, an average of roughly two deaths annually, spread across hospitals, care homes and patients’ own homes. MHRA is explicit that the pattern is not confined to any one manufacturer, hoist model or care setting — which is precisely why the response is a system-wide alert rather than a targeted recall.

What keeps going wrong

The alert lists a cluster of recurring, largely human and organisational causes rather than a single design flaw: incompatible combinations of hoist and sling — a mismatch MHRA flags as a common thread, since not every sling is rated for every hoist — damaged or incorrectly fitted sling attachments, inadequate pre-use checks, overdue maintenance and servicing, incorrect sling selection for a given patient or transfer, insufficient staff training, and outright failure to follow manufacturers’ instructions for use. None of those causes require a product recall to fix; all of them require providers to change how hoists and slings are checked, matched and used day to day.

• Incompatible hoist-and-sling combinations, where a sling is not rated or designed for the specific hoist it is used with.
• Damaged or incorrectly fitted sling attachments.
• Inadequate pre-use checks before a transfer begins.
• Overdue maintenance and servicing of hoist equipment.
• Incorrect sling selection for the patient or the transfer being performed.
• Insufficient staff training, and failure to follow manufacturers' instructions for use.

Five actions, one year

MHRA is requiring every organisation responsible for using, purchasing or maintaining patient hoists to complete five actions within 12 months of the alert. The first is standardised pre-use checks before every transfer, including a new “pause-and-check” step: staff must stop once a sling has taken up the patient’s weight and is taut, before lifting the patient fully clear, a step MHRA singles out as particularly important for loop-type sling attachments. The second is a review of the compatibility of every hoist-and-sling combination currently in use. The third is maintaining comprehensive equipment inventories. The fourth is ensuring compliance with servicing and inspection requirements. The fifth is role-appropriate training — covering the specific hoist and sling types in use, correct attachment and fitting technique, how to recognise an unsafe equipment state, and when to stop, escalate and report an incident — extended not just to staff but, where applicable, to patients and their families or carers.

“Patient hoists are vital devices that support safe and dignified care, but when they are used incorrectly or not properly maintained, the consequences can be devastating,” said Dr Alison Cave, MHRA’s chief safety officer.

What it means for manufacturers and providers

The alert is directed at providers — the hospitals, care homes and home-care services that buy, maintain and operate hoists and slings — rather than at manufacturers directly, but it does not leave manufacturers untouched. A safety pattern this consistently traced to compatibility mismatches and unclear instructions for use puts pressure back on device makers to sharpen compatibility labelling between hoists and slings from different ranges or manufacturers, and to make instructions for use and training materials clear enough that the errors MHRA describes stop recurring. For RA/QA teams on the provider side, the practical task is more immediate: an inventory review, a compatibility audit and a training refresh, all against a 12-month clock that started running on 16 September.

Frequently asked questions

What did MHRA announce, and when?

A National Patient Safety Alert, reference NatPSA/2026/005/MHRA, published 16 September 2026, covering all types of patient hoists and slings used across hospitals, care homes and people's own homes in the UK.

What is the scale of the problem?

MHRA received 22 reports of incidents with a fatal outcome during patient hoist or sling transfers between January 2015 and December 2025 — an average of roughly two deaths a year. The agency says the problem is not confined to any single manufacturer, model or care setting.

What caused the incidents?

Recurring root causes identified by MHRA include incompatible hoist-and-sling combinations, damaged or incorrectly fitted sling attachments, inadequate pre-use checks, overdue equipment maintenance, incorrect sling selection, insufficient staff training, and failure to follow manufacturers' instructions for use.

What must providers do, and by when?

MHRA requires five actions within 12 months of the alert: introduce standardised pre-use checks, including a new pause-and-check step before a patient is fully lifted; review the compatibility of every hoist-and-sling combination in use; maintain comprehensive equipment inventories; ensure compliance with servicing and inspection schedules; and deliver role-appropriate training on hoist and sling use, including when to stop, escalate and report.