The enormity of the NHS patient safety culture development challenge

Over the years nobody has ever said that developing a patient safety culture in the NHS was going to be easy. It has proved and still is proving exceptionally difficult. I say this because of the frequency of major patient safety crises that occur in the NHS and the constant reminders of systemic problems.

The Parliamentary and Health Service Ombudsman (PHSO) (2023) in a controversially titled report, ‘Broken Trust: Making patient safety more than just a promise’, clearly laid out the patient safety challenges that face the NHS and what needs to be done to improve matters. We know what the issues are and most often the solutions. However, as the charity, Patient Safety Learning (2022), and the PHSO have noted, there is an implementation gap between theory and practice in NHS patient safety.

Improvement recommendations are made after a patient safety crisis, often repeated ones, but the system does not change much or at all. Errors are repeated, lessons go unlearnt. This might seem a pessimistic appraisal of the patient safety culture development efforts but after reading some recent reports, they have not given me cause for immediate optimism. There are the green shoots of some positive developments but there are still significant challenges ahead. In this column I will discuss several recent patient safety reports that illustrate, in my view, the enormity of the patient safety challenges that face the NHS.