From theory to practice

The Health Foundation road-tested the framework with three NHS organisations, and sought feedback through a public consultation and a patient safety summit. The feedback we received was very positive, but stressed the importance of helping people understand how the framework can best be applied in practice – something that this guide aims to contribute to. We are funding an improvement programme to explore more fully how the framework can be applied in various practice settings. We are also working closely with organisations such as the Care Quality Commission to inform how they inspect the safety of organisations.

What might the framework mean for different levels of the health system and for the public?

  • Front line health and care professionals should reflect on the value of data currently collected, and identify opportunities to collect more meaningful data about the safety of their services. When we tested the framework, front line professionals told us that it widened their thinking about patient safety, and helped to clarify the value of collecting different data and measures.
  • Managers and support staff should work with clinical staff to ensure that learning, feedback and action are prioritised following the review of safety information. When we tested the framework, managers told us that the framework helped them to reflect on ‘where they are’. They said that it enabled them to see the flaws within their current systems and challenged how they view their own roles.
  • Board members should ensure that staff have the time and resources to explore new measures so that the safety information they ask for, and receive, is meaningful. When we tested the framework, boards told us the framework provided them with a structure to analyse what they were doing, that it widened their thinking about safety and helped them to ‘make the connections’ between different safety measures and activities.
  • Government, regulators and national agencies should design their systems for oversight and regulation in a way that allows organisations to demonstrate their safety, rather than their compliance with prescriptive, centrally-mandated measures. When we tested the framework, board members and managers spoke of their frustration about the current focus on externally imposed measures above those that are important to front line staff for improving safety.
  • As a result, Patients and the public should increasingly expect to see information that is important to them, which reflects the safety of the service they are using today, not just how harmful it has been in the past. When we spoke to patients and the public, they told us that their relationships with staff, and how staff communicate with them, are the most important factors to feeling safe.

Useful prompts for using the framework

Figure 2 overleaf suggests some prompts for using the framework. These aren’t a substitute for the findings of the research, but are intended as a helpful reminder of its key points if you are applying the framework to your own context.

Figure 2: The framework for measuring and monitoring safety – and useful prompts for using it in practice

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