29 March 2019

The most important realisation for us all at Sign up to Safety over the last five years is that in order to improve or maintain patient safety we cannot simply focus on patient safety.  We have to focus on how we work.  How we work together, how we lead, how we talk to one another and develop not only relationships but friendships, how we make decisions, how we cope with our daily dilemmas, how we adjust and adapt every day and most importantly how we behave.  This means creating a balanced approach to safety, addressing the blame culture and caring for the people that care are our final three key messages.

We have talked to thousands of people about our concepts and ideas and without fail the recipients say how much it resonates with their everyday, how finally they feel that someone is hearing them and understanding what they are feeling.  Also when we talk with people across healthcare we often get asked, ‘but what is the one thing we should do now’.

We are mindful that people are really pressured and it would be great if we could just point them in the direction of ‘one thing’.  We are also mindful of the fact that Jim Collins once said ‘if you have more than three priorities, you have no priorities’ (Collins 2006).  As Brené Brown also says, ‘if everything is on the list is important then nothing is truly a driver for you’ (Brown 2018).

So our usual response is ‘there is no one thing’ especially given the fact that it is not just about safety it is about ‘everything to do with the way we work’.  However, in some respects, there is ‘a one thing’.  The combination and integration of a balanced approach to safety, with urgently addressing the blame culture, building a restorative just culture together with kindness, joy, empathy, appreciation and gratitude and the final ingredient of caring for the people that care.  There are countless connections between all of these.

Throughout our work we have been hugely mindful of how much we need to move away from transient and short term attempts to improve the safety of patient care and help people work safely for future generations and beyond.  As James Kerr in his book about the All Blacks, Legacy (2013) says; ‘Be a good ancestor – plant trees you will never see’. Kerr goes on to say that we are ‘but a speck in the moment of time situated between two eternities, the past and the future’.

Therefore the time is right for us to inspire a social movement for safety for future generations and beyond.  Sustained change has to grow from the grass roots – it needs to be emergent rather than forced.

A movement of people can shift us away from the pure focus on failure to one of balancing failure and success to achieve safety.

A movement of people could help address the blame culture and incivility.

A movement of people could help people talk to each other and care for the people that care.

What can you do? 

Be part of this movement, grow a community around you and motivate them to use the concepts and ideas we have all shared with you.  Say thank you to the people around you, value and appreciate them, go out of your way to help people who need it.  Develop relationships and friendships and spread the messages as you go along.  People are desperate for hope and to a move away from the relentless negativity to a more positive interpretation of safety and you can do that for them.

True leaders are stewards of the future.  They take responsibility for adding to the legacy. It is our hope that Sign up to Safety has added to the legacy of work in relation to safety and that our actions over the last five years will echo beyond our time.  All we ask is that you take your open hearts and minds and be a good ancestor and plant trees you will never see.

As we approach our final week as a team next week, and with this, our final message to you, we want to say thank you for being part of the most wonderful five years any of us could have hoped for.

The Sign up to Safety Team

What is a safety culture?

A safety culture is at the heart of helping people work safely.  The right culture is one that is kind and fair (often referred to as ‘just’) and helps people build strong relationships with each other.  We believe it is essential to better care for those who care for patients to foster a safety culture where you are.

Connecting through conversations

Thousands of people have experienced for themselves how different it feels to be part of a conversation where kindness, curiosity and humility are front of mind. It is the very foundation of working safely. You don’t need to wait for permission to seize your chance to make change happen.



It’s harder than you think but one of the most generous things to do…


Asking Questions

Dig deeper, grow the conversation and discover more…



This work is grounded in evidence from across the world…


Why it Matters

The right conversations can help make a safety culture a reality…


Being kind is the most important thing you can do
to help change the culture in healthcare today

Kindness matters

Kindness is key to helping a safety culture grow.

Everywhere we look more and more people are understanding that how we behave and the values we live by can have the most significant impact on our work and every aspect of our lives.

How we can help you

The right conditions and mind-set are needed to help bring about a strong safety culture where people feel cared for and supported. This isn’t about something ‘new’ or a ‘quick fix’ thrown at front line staff as the latest fad. We can help you experience and role model the values, attitudes and behaviours that help you work safely.

  • Are you really listening, or are you just waiting for your turn to talk?

    Robert Montgomery Author

Learn from others like you

Read about our members’ own experiences of putting into practice what we have all learned together about building a safety culture, and hear from the Sign up to Safety team who share encouragement, knowledge and reflections on the latest thinking to help you.

Kindness and patient safety

Adam Mohamed

“There is a growing recognition that kindness is vital for human connections and relationships. However, it is often seen as ‘fluffy’ to talk about being kind or compassionate or caring. It is seen as more of an afterthought than a driving force…”

Improve incident reporting culture

Justin King

“At the start of our journey at University Hospitals Coventry & Warwickshire we had relatively low incident reporting rates and staff were telling us that they didn’t hear about the outcome of incident reports…”

Our members

When Sign up to Safety launched back in 2014, we aspired to bring organisations together behind a common purpose; to create the conditions for making care safer. We started with just 12 but before we knew it, we had grown and grown and we’re now a community of over 500 organisations and practices from across the NHS and beyond.

Sign up to Safety comes to an end in March 2019, so we are no longer encouraging new members to join. But if you’d like to receive our free fortnightly newsletter full of advice, latest thinking, opinion and encouragement, which will run right up until then, you can join the mailing list below.

About our membership

Since 2014 our community has connected organisations and individuals who are working hard to make care safer. Although our day to day work may differ from person to person, we all want the same thing; to help the right safety culture grow and flourish.

We have supported our members to work on what matters to them, and to understand how caring for each other and building strong relationships can help. Over the years we provided information and insights to help in convincing others to give it a go, as well as ideas and positive encouragement. All in an easily digestible format via our website, social media and newsletter.

Our aim has been to inspire people to play your part in making patient safety everybody’s responsibility, and a positive and empowering approach to learning the norm, not the exception.

Connect with us


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