Safety culture

Safety culture is one of the two key foundations of the NHS patient safety strategy. We define a positive safety culture as one where the environment is collaboratively crafted, created, and nurtured so that everybody (individual staff, teams, patients, service users, families, and carers) can flourish to ensure brilliant, safe care by:

  • Continuous learning and improvement of safety risks
  • Supportive, psychologically safe teamwork
  • Enabling and empowering speaking up by all.

Safety culture learning from best practice

We understand that organisations are at different stages of their safety culture development and that one size does not fit all. We have been working with organisations across all sectors of healthcare using a Safety-II inspired approach to learn from every day work to understand how they are supporting safety culture improvement. This has allowed us to create the Safety culture: Learning from best practice report, which also includes a number of case studies.

Within safety culture, context is everything and improving safety culture is not just about what interventions happen, it is also about how these interventions happen ie how change is implemented.

Engaging, involving and supporting patients, families, carers and staff

With the introduction of the Patient safety incident response framework there is continued emphasis on engaging and involving patients, families and staff following a patient safety incident. This supports the Just culture guide which encourages managers to treat staff involved in a patient safety incident in a consistent, constructive and fair way.

We know that positive patient safety and healthy organisational culture are two sides of the same coin. A culture in which staff are valued, well supported and engaged in their work leads to safe, high-quality care. The people promise describes what good staff experience should look like, including ‘we are safe and healthy’ and this is supported by the Culture and Leadership programme.

We are exploring how a focus on staff safety can support patient safety. This means both psychological safety and physical safety, including considering staff wellbeing, engagement, fatigue, burn-out, presenteeism, and the impact these can have on risks to patients and staff alike.

Improving safety critical spoken communication

Every 36 hours the NHS deals with over a million patients and each of these contacts probably generates discussion between staff about a patient’s care. Yet we know from serious incident investigations that communication failure is a common finding: we have come to expect direct or indirect reference to communication in most investigation reports.Our  research examines the issues surrounding both good and poor spoken communication of safety critical information. It identifies six key areas that present challenges to spoken communication.