Take the patient safety pledge

The past decade has seen a great deal of work focused on patient safety, including incident reporting systems, alerts and guidance, and reducing avoidable harm. But it is hard to find evidence that we have significantly reduced human error, or the number of incidents of avoidable harm.

Over time, it was recognised that addressing patient safety problems is difficult, so we sought ever more complex solutions. But our learning has, at times, seemed fleeting. We have made changes following an incident or encouraged staff to adopt the latest solutions, but these are often slowly eroded, and unless we design the system differently we resort to old habits. We also struggle with scalability, transferability and spread.

In response, a set of initiatives to help the NHS in England improve patient safety was launched in 2014. The initiatives included a three-year campaign called Sign up to Safety; patient safety collaboratives run by the 15 academic health science networks to tackle intractable issues such as falls and medication errors; and the Q safety fellow initiative, led by NHS England and the Health Foundation, to increase skills and knowledge in quality improvement across the entire NHS.

Sign up to Safety aims to support nurses and others working across health and social care to implement findings of Don Berwick’s 2013 review of patient safety and to create the conditions for a safer NHS. ‘Conditions’ means the right culture, resources and organisational context. To participate, organisations are asked to commit to five pledges: putting patient safety first, collaboration, supporting staff, being open and honest with patients, and sharing learning. As nurses, we too can commit to the pledges.

Organisations are asked to review their past three to five years and consider what worked and what they could do better, and the scale and nature of harm in their organisation. This is all documented in a safety improvement plan. The campaign stresses the importance of truly understanding the culture; sadly, many of our organisations continue to stigmatise individual nurses rather than supporting them to get it right.

As the campaign approaches its first anniversary this week, we have more than 260 participating organisations and 250 individual pledges.

Over the next year we will build on our unique approach to learning. Our focus will be on how people are making a difference – what works to create effective and sustained change. We will be exploring with participants how they are overcoming challenges.

Our commitment is to help organisations and individuals working in the NHS, no matter where they practice.

Sign up to Safety is for everyone. Mark the campaign’s one-year anniversary this week by joining as an individual and making your own personal safety pledges.

With the theme ‘Sign up to Safety + Me’, the anniversary is the perfect opportunity to consider how you and your team can use the campaign to improve the safety of patient care. Free resources are available at

Webinars will be hosted throughout the anniversary week, with different guest hosts sharing lessons learned so far. Complete the pledge form or register for these events at

Take part in a live Twitter chat with the campaign’s regional leads on June 24 at 4pm: @signuptosafety

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