Background Despite growing recognition internationally that patients can help to promote their own safety, little evidence exists on how willing patients are to take on an active role.

Objectives To investigate medical and surgical patients' perceived willingness to participate in different safety-related behaviours and the potential impact of doctors'/nurses' encouragement on patients' willingness levels.

Design Cross-sectional exploratory study using a survey that addressed willingness to participate in different behaviours recommended by current patient safety initiatives. Interactional behaviours (asking factual or challenging questions, notifying doctors or nurses of errors or problems) and non-interactional behaviours (choosing a hospital based on the safety record, bringing medicines and a list of allergies into hospital, and reporting an error to a national reporting system) were assessed.

Participants 80 medical and surgical patients from an inner city London teaching hospital.

Findings Patients' perceived willingness to participate was affected (p<0.05) by the action required by the patient and (for interactional behaviours) whether the patient was engaging in the specific action with a doctor or nurse. Patients were less willing to participate in challenging behaviours. Doctors' and nurses' encouragement appeared to increase patient-reported willingness to ask challenging questions, but no other consistent findings were observed.

Conclusion Patients do not view involvement in a range of safety-related behaviours uniformly. Particular efforts are needed to encourage patients to participate in novel or challenging behaviours as these are behaviours where patients appear less inclined to take on an active role.