• Patient safety
• safety culture
• teamwork

We read with interest the article by Leape et al in your December issue, ‘Transforming healthcare: a safety imperative’ emphasising the importance of communication, teamwork, respect, trust and transparency in ensuring a culture of patient safety and avoiding the ‘sick system syndrome.’1 This is very timely, given the recent Dr Foster Hospital Guide 2009 which shows that while there have been encouraging improvements in patient safety in the NHS in the UK in recent years, worrying variations still exist.2

To explore what role work culture in the NHS might play in this variation, the National Institute for Health Research Collaboration for Leadership in …