Safety culture is one of 2 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 – that is, how change is implemented.

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

A just culture is about creating a culture of fairness, transparency and learning.

It recognises that success or mistakes are the product of many factors and focuses on changing systems and processes to make it easier for people to do their jobs safely.

It is about ensuring everyone is confident they will be treated fairly when something goes wrong.

Patient safety incidents and the PSIRF

The 4 core principles of the patient safety incident response framework promote a positive safety culture, through the application of systems-thinking, supportive oversight, and the compassionate engagement of those affected by patient safety incidents.

Patient safety incidents are usually signs of underlying systemic issues that require wider, system-level action. Action singling out an individual is rarely appropriate.

Considering individual actions and the Being fair tool

By treating staff fairly, the NHS can foster a culture of openness, equity and learning where staff feel confident to speak up when things go wrong. Supporting staff to be open about mistakes allows valuable lessons to be learnt and prevents errors from being repeated.

However, in rare circumstances a learning response may raise concerns about an individual’s conduct or fitness to practise.

It is in these specific circumstances that the Being fair tool can help you decide what next steps to take.

Positive culture

We know that positive patient safety and healthy organisational culture are 2 sides of the same coin.

A culture in which staff are valued, treated with civility and respect, 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 1 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 6 key areas that present challenges to spoken communication.