We welcome that NHS Improvement has set out clear commitments to bringing a more strategic, planned and aligned approach to patient safety policy across the NHS. This is vital, alongside the appropriate training, expertise and resources for NHS organisations and staff, to full embed an effective safety culture across the NHS. We are also pleased to see the aims and principles of the strategy are in line with previous policy and proposals are aligned to priorities already underway.

In our view, the main challenges with the proposals included in the document lie in facilitating and enabling the changes required for the strategy's ambition to be realised. Regulation pressures, misaligned requirements around reporting, bureaucratic burden, local variation, and workforce shortages will all present barriers to delivering the strategy. Trusts will need to be supported to prioritise this work and changes to process will need to be given time to mature. Clarity on how outcomes will be assessed and measured will also be essential.