“Colleagues are your work family…You are allowed to love them and cherish them and to be as kind to them as they are to their patients.”

Elin Roddy, Respiratory/gen med consultant at The Shrewsbury and Telford Hospital NHS Trust

What are the most important lessons we’ve learned over Sign up to Safety?

For each of us, our day is made up of dozens of conversations. It’s likely we take these for granted, but how we talk to each other can make a huge difference to how we feel, how we think, the decisions we make, and ultimately the actions we take.

The team’s roles come to an end in March 2019, so we are celebrating the ending of our work. Two principles of the campaign since the very beginning were local ownership and for our members to work on things that matter to them.  So, Sign up to Safety still belongs to every person who has been involved to carry on the great work they have been doing so far.

To help, we are sharing what we have learned in the last five years – which we feel is the most important part of the campaign.

We know now that the way we think about patient safety in healthcare needs to change. Achieving patient safety is not about short-term projects to reduce individual harms; it is much, much more than that.

There are emerging theories (safety II), the world of behavioural insights, positivity and positive deviance, learning from excellence and addressing behaviours such as incivility.  There is also a deeper understanding developing of the learning and restorative just culture that healthcare needs.  This is a wonderful time to be working in safety.

But to add to this, in our view…

 Safer care is only possible if we care for those who care for patients

In fact, we believe it should be the central driver to improving the safety of patient care.

How has our thinking led us here?

  • Healthcare is incredibly complex. We must take advantage of all opportunities to learn about why things don’t go as expected, so it is important to study the way we do things all the time (when they go right and when they go wrong).


  • This complexity makes it a difficult environment to work in day to day; this coupled with current pressures, unhelpful cultures, high rates of stress, incivility and bullying, makes it really hard for healthcare staff to work safely.


  • To help the system as a whole to perform well (efficiently, effectively, safely), we need to help individuals (the people who make up the system) to perform well (work efficiently, effectively and safely).


  • The safety of patients is dependent on the members of staff who interact with them being physically, psychological and emotionally well, and able to cope with the complexity of their day to day work.


  • To be physically, psychological and emotionally well, people need to be fed, watered, emotionally supported, thanked, rewarded, recognised, cared for, even loved, and helped to feel proud about what they do and to feel joy (or enjoy) their work.


  • Kindness and civility needs to be encouraged and expected, with people given the opportunity and time to connect with those they work with in order to create the positive, open and constructive relationships that allow people to speak out and be heard, when things go well and when things don’t turn out as expected.


  • Staff wellbeing is increasingly being understood as almost the most important aspect of preventing error and harm, and the time has come to apply these insights to the way we approach patient safety in the NHS.


  • We each have a part to play in choosing the values and behaviour that guide our relationships with each other, and we have the power and influence to help and support the people we work with, alongside, for and on behalf of.

As our work draws to a close, we ask you to think about what we’ve said here, and perhaps talk about these points with those you work with. What do they mean to you? What do you feel about what we’re saying? Feel free to share anything on your mind with us on social media or via email.

This is the last thing we want happen to our work and have designed our information and resources on this website so that that anyone can use them, regardless of their role or the setting they work in.

Simplicity is extremely powerful. So rather than turning these conversations into a new tool or intervention, we ask you to use the information and resources on our website to just talk to each other and then discover how that may connect people around working safely.