Key points

  • A learning environment is necessary to achieve the profound cultural change being asked of the NHS. There is a pivotal role for the government and NHS England in creating this.
  • A large-scale safety collaborative programme has the potential to provide benefit, but NHS England needs to strike the right balance between providing accountability and achieving genuine ownership from front-line teams.
  • The focus on measuring safety is welcome, but measures should be developed to assess the future risk of harm, not just the occurrence of past harm.
  • The government also needs to be clear how the publication of data will improve safety.

The focus of this briefing is on bridging the gap between the actions set out by the government in Hard Truths and their practical application by people working in the service.

We use the experience gained from our research and improvement programmes to suggest to policy makers how the continual reduction of harm can be achieved by measuring safety comprehensively and by building the capability of individuals, organisations and systems.

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