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Qual Saf Health Care 2005;14:135-139
© 2005 BMJ Publishing Group Ltd.


WORLD VIEW

Implementing a national strategy for patient safety: lessons from the National Health Service in England

R Q Lewis1, M Fletcher2

1 Special Advisor, National Patient Safety Agency, UK and Visiting Fellow, King’s Fund, London, UK
2 Assistant Director of Patient Safety, National Patient Safety Agency, London, UK

Correspondence to:
Dr R Q Lewis
National Patient Safety Agency, 4–8 Maple Street, London W1T 5HD, UK; richard.lewis{at}npsa.nhs.uk
ABSTRACT
Improving patient safety has become a core issue for many modern healthcare systems. However, knowledge of the best ways for government initiated efforts to improve patient safety is still evolving, although there is considerable commonality in the challenges faced by countries. Actions to improve patient safety must operate at multiple levels of the healthcare system simultaneously. Using the example of the NHS in England, this article highlights the importance of a strategic analysis of the policy process and the prevailing policy context in the design of the national patient safety strategy. The paper identifies a range of policy "levers" (forces for change) that can be used to support the implementation of the national safety initiative and, in particular, discusses the strengths and limitations of the "business case" approach that has attracted recent interest. The paper offers insights into the implementation of national patient safety goals that should provide learning for other countries.


Keywords: patient safety; government policy; National Health Service




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