Taking the measure of safety culture

Much is made of the NHS Staff Survey and rightly so, and, although it tackles many broad areas of how it feels to work in an organisation, what really matters to clinicians is how to practise with patient safety at the heart of everything that we do, and how safe it feels to practise.

In late 2018 the Care Quality Commission (CQC) released its report Opening the Door to Change (CQC, 2018a), with the CQC's Chief Inspector of Hospitals, Professor Ted Baker, calling on the NHS to promote a change in safety culture:

‘Everyone can play a part in making patient safety a top priority. But there is a wider challenge for us all to effect the cultural change that we need, to have the humility to accept that we all can make errors—so we must plan everything we do with this in mind.’

The CQC review was based on evidence gathered by inspectors during visits to 18 NHS trusts and through group discussions with staff, patients, the public and experts from other safety-critical industries. Although the review found a strong commitment from NHS staff to the safety of patients, it also found the current patient safety system to be complex, with trusts receiving guidance from a number of bodies, leading to confusion and a lack of clarity on which external organisations can provide information and support. Added to this is the impact of increasing patient demand and staff shortages, which leave little time for staff to implement safety guidance effectively.