Chapter 12 Sign up to Safety

Chapter 12 describes the start up of the patient safety campaign Sign up to Safety.

Launched in 2014 it was set up to help the NHS in England reduce avoidable harm.  We instantly knew we wanted to do something different.  We did not want to be ‘yet another top down initiative’, we also did not want to focus in the same way patient safety campaigns have focused before; harm topic by topic.  What we want to do was to create the conditions for safer care; the culture, behaviours, attitudes and values that are so very important as the foundation for everything else.

The lessons we have learnt apply to anyone.  Leaders of organisations, leaders of projects, team members and people who work in change.  They apply to any care setting – wherever care is provided they are relevant.

  • It is important to help people but not simply ‘tell them this is what you must do’
  • That if you trust people they can do some spectacular things
  • That social movements cant be ‘engineered’ or ‘created’ – they emerge if you provide the right principles
  • Campaigning is a much underused method for change in patient safety
  • Don’t say one thing and then do the other – i.e. be genuine and mean what you say
  • Listen more than you talk
  • Use words and language differently – to thank, to reward, to appreciate and to be kind

The campaign used the Ganz model of leadership (Ganz 2009)….

The difference between leadership as a position, and leadership as a practice

Ganz says (2010) that we act from habit, we don’t choose, we just follow the routine and that when the routines break down and no one tells us what to do we start to make real choices about our lives, communities and futures. We have found that by not telling people what to do we have in fact energized them.  We have surprised them and some have told us they found this really exhilarating.

To build trust and engagement the campaign created a brand that was synonymous with kindness, caring and compassion. In today’s stressful and challenging healthcare environment the last thing people needed was another stick.  We have shown that kindness works; thanking people, valuing them and being thoughtful of all around us are vital to creating the right culture for safety and are leadership traits that we both embody and promote. The question we get asked most often is ‘how can we turn the NHS and all who work in it into an organisation that cares about them?

We believe that we can do this by listening to one another again. 

Listening to another human being starts to create a relationship, starts to help us understand them more. The reason why we believe this so fervently is that ‘not listening’ or ‘not being heard’ or ‘not being able to speak out’ has led to harm on numerous occasions.  Listening means we hear someone else’s point of view rather than forcing our own on to others.  Listening means that we recognise that we are not better than anyone else but that we are just different and that we all add value.  We move away from our judgments and assumptions towards curiosity.  This means we start to learn more about what could be safer, what could or should be changed.


Ganz M (2010) Leading Change in Handbook of Leadership Theory and Practice Eds. N Nohria, R Khurana Boston: Harvard Business Press ISBN 13: 978-1-4221-6158-6