The complex process of developing an NHS patient safety culture

The question whether the NHS has or is even in the process of developing a satisfactory patient safety culture is a profoundly complex one, and there is no simple yes or no answer. The answer you get will depend on who you ask. In my columns I have argued that the NHS is still some way off from developing a satisfactory NHS patient safety culture. The many crises involving care quality and patient safety crises – such as East Kent maternity care (Kirkup, 2022) – show major systemic NHS patient safety cultural failings.

Taking a broad view, the NHS has made some definitive progress with initiatives such as the Patient Safety Incident Response Framework (PSIRF) (NHS England, 2024), and the NHS Patient Safety Strategy (NHS England/NHS Improvement, 2019), but the pace needs to significantly quicken.

NHS England (2025), in its recent update on progress with the NHS Patient Safety Strategy, has found some significant signs of improvement: