• emergency care systems

‘The NHS in England can become the safest health care system in the world. That will require unified will, optimism, investment, and change... rules, standards, regulations and enforcement have a place in the pursuit of quality, but they pale in potential compared to the power of pervasive and constant learning’; so says Donald Berwick, the wise elder statesman and guru of health care improvement, advocate of a ‘no name—no blame’ approach to clinical error and, incidentally, a former advisor to Barack Obama. His report to the British Government, released in August, is a master class in common sense and wisdom.1

Some statements worth noting:

• Patient safety problems exist throughout the NHS: the whole NHS should strengthen patient safety now and into the future

• NHS staff are not to blame: it is not scientifically justifiable to blame the staff or label them as uncaring, unskilled, or culpable. There may be exceptions, but most staff want to do a good job, to reduce suffering and be proud of their work

• Incorrect priorities do damage: The Mid Staffordshire tragedy and wider quality …