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From harm to hope and purposeful action: what could we do after Francis?
  1. Tricia Woodhead1,
  2. Peter Lachman2,
  3. James Mountford3,
  4. Laura Botwinick4,
  5. Carol Peden5,
  6. Kevin Stewart6
  1. 1Safer Care South West, Royal United Hospital Bath, Bath, UK
  2. 2Great Ormond Street Hospital NHS Foundation Trust, London, UK
  3. 3UCLPartners, London, UK
  4. 4Graduate Program in Health Administration and Policy, The University of Chicago, Chicago, Illinois, USA
  5. 5Royal United Hospital, Bath and NHS England (South), Bath, UK
  6. 6Clinical Effectiveness & Evaluation Unit, Royal College of Physicians, London, UK
  1. Correspondence to Dr Tricia Woodhead, Medical Lead for Safer Care South West, Royal United Hospital, Combe Park, Bath BA1 3NG, UK; tjw1010{at}


Responses to the reports on the inquiry into Mid Staffordshire have resulted in calls from politicians, NHS leaders and the public to improve care across the NHS in England. However, the substance of what needs to be done remains unclear. In this paper, we offer seven key ‘ingredients’ required to sustain improvement of care, supported by evidence drawn from published literature. We believe that empowering and upskilling the front-line workforce in understanding and implementing improvement techniques, supported by changes at system and policy level and reinforced by what leaders say and do, will result in sustainable benefit for patients and families, as well as greater satisfaction for staff.

  • Patient Safety
  • Medical Education
  • Healthcare Quality Improvement
  • Leadership
  • Collaborative, Breakthrough Groups

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