Top picks for staff psychological safety

Summary

Psychological safety is when someone feels they are safe to speak up with ideas, questions, concerns or mistakes without fear of being punished or humiliated. In healthcare, developing a culture of psychological safety is essential to ensuring patient safety. It helps to create and maintain an environment where patient safety issues can be raised, discussed and resolved. A psychologically safe environment supports incidents of avoidable harm being responded to with empathy, respect, rigour and action for improvement.

Whilst the first priority after any incident of avoidable harm will be to support patients and their families, staff directly and indirectly involved should also be provided with the support they need following an incident. Organisations should have a support structure in place to look after their staff’s mental health and wellbeing.

At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples. 

In this ‘Top picks’, we have pulled together resources, blogs and tools from the hub to support staff and organisations in developing a culture where everyone feels psychologically safe.

Content

1 Paul O’Neill: A psychological safety success story

We often talk about failures of psychological safety – what happens when, in an absence of psychological safety, concerns are not raised, questions remain unasked, mistakes are hidden and no one shares their improvement ideas. Unsurprisingly, the consequences can be catastrophic. But what happens when leaders prioritise psychological safety, and how can it transform their organisations? Paul O’Neill at Alcoa was one such example and highlights that cultures can change, with leadership and commitment to psychological safety and addressing the ‘work as done'.

2 Speak Up for Safety: A new workshop for healthcare staff about the importance of Just Culture

The culture of a healthcare organisation can determine how safe its staff members feel to raise concerns about patient safety. Bella Knaapen, Surgical Support Governance & Risk Management Facilitator and Sarah Leeks, Senior Health & Wellbeing Practitioner at Norfolk and Norwich University Hospitals NHS Foundation Trust, have developed ‘Speak Up For Safety’, a Just Culture training workshop that aims to help staff, at all levels, understand the importance of creating an environment that encourages people to share concerns and feedback.

3 Amy Edmondson: The importance of psychological safety

As a leader how can you foster a work environment where people feel safe to speak up, share new ideas and work in innovative ways? In this video from the Kings Fund, Amy Edmondson, Novartis Professor of Leadership and Management at the Harvard Business School, talks about the importance of psychological safety in health and care and what leaders can do to create it. 

4 Staff Support Guide: a good practice resource following serious patient harm

This guide from Patient Safety Learning and the Safer Healthcare Biosafety Network, as part of the Safety for All campaing, outlines what good practice support looks like for a staff member following a serious safety incident, and through the subsequent investigation and aftermath.

5 System-level changes are essential to improve the psychological wellbeing of NHS staff

In this study, researchers reviewed literature on the causes of stress and anxiety among nurses, midwives and paramedics. They recommended that senior leaders, managers and clinicians improve working conditions and shift from individual interventions only (such as mindfulness or resilience training) to include a focus on system-level culture change.

6 Key themes emerging from our ‘Speaking up for patient safety’ interview series

At the beginning of 2025 we launched our video interview series Speaking up for patient safety. The series is hosted by Peter Duffy, NHS whistleblower and Chair of the Healthcare Working Group at WhistleblowersUK, and Helen Hughes, Patient Safety Learning’s Chief Executive. In each interview we hear from someone who has raised concerns about patient safety in healthcare, often at great cost to their own career and personal life. They share their story and their reflections on what needs to be done to improve organisational cultures so that when staff raise patient safety issues, their concerns are responded to appropriately and not dismissed because they are inconvenient to address. Alongside the thread of bravery and tenacity that runs through each contributor, a number of common themes come up time and again as people share their experiences. In this blog, Helen and Peter look at some of these themes and outline their implications for people who speak up or whistleblow.

7 The whistleblower playbook

'The whistleblower playbook' infographic illustrates how some organisations respond to staff raising concerns about patient safety. 

8 Royal Society of Medicine: Aware to Care resource pack

Psychological safety resource pack for all staff on a wide range of topics, including improving team communication and dynamics, tools to build awareness of current state of mind and behaviour, moving from reacting to responding, building and balancing compassion between others and self.

9 Trust talk! The language of leaders who create psychologically safe teams

Language is powerful. Our words are important. Few things are likely to have a more frequent or profound impact on the trust (or mistrust) levels of our teams than the words we speak on a daily basis. Our words can influence our teams to frame events in positive or negative, helpful or hindering, and trusting or fearful ways. Psychologist Clive Lloyd looks at how the language we use can create psychologically safe teams.

10 Vicarious trauma: The invisible epidemic

In healthcare, an insidious epidemic lurks beneath the surface, affecting the very individuals tasked with providing care: vicarious trauma by empathy. Despite its profound impact, this phenomenon remains largely unrecognised and under-discussed within the sector. As leaders, it is imperative that we shed light on this invisible trauma and acknowledge it as one of the greatest challenges facing our industry, as Margarida Pacheco explains in her blog.

11 How can our team move past a traumatic event?

After an extreme traumatic event there are things that you can do to help yourself, and your colleagues, to move on. Fiona Day, medical and public health leadership coach and chartered coaching psychologist, Stacey Killick, consultant paediatrician at Glan Clwyd Hospital, and Lucy Easthope, professor in practice at Durham University’s Institute of Hazard, Risk, and Resilience and adviser on disaster recovery give their tips in this BMJ article.

12 Strategies for improving clinician psychological safety in reporting and discussing diagnostic error

One of the best ways to collect information about diagnostic errors is through self-reporting by patients and healthcare professionals. This issue brief from the Agency for Healthcare Research and Quality looks at how to foster psychological safety and organisational safety culture in order to reduce harm from diagnostic error. 

13 Safety Incident Supporting Our Staff (SISOS): A second victim support initiative at Chase Farm Hospital

Suicide rates for doctors, nurses and allied healthcare workers are rising and being involved in a safety incident increases this risk. The need to support staff when things go wrong is evident. We come to work to do the very best we can for our patients, often ignoring and at the cost of our own health. Most adverse incidents happen, not because we are bad at what we do, but because of system failure. As professionals who care passionately about our work, we blame ourselves when things go wrong. In a series of blogs. Carol Menashy shares her experiences of setting up and developing Safety Incident Supporting Our Staff (SISOS).

14 Pyschological safety videos

This channel is dedicated to useful, entertaining and informative content about psychological safety, human organisational performance, and organisational learning.

15 What can the NHS do to help staff speak up about concerns?

How do you ensure staff’s concerns are voiced and heard in a complex system like the NHS? A recent decline in doctor’s confidence to raise concerns about patient safety has led to renewed calls for stronger regulation of managers – but a broader approach is likely to be vital to encouraging staff to speak up writes Professor Graham Martin, Director of Research at THIS.

16 Balancing care: The psychological impact of ensuring patient safety

In this blog, Leah Bowden, a patient safety specialist, reflects on the impact her job has on her mental health and family life. She discusses why there needs to be specialised clinical supervision for staff involved in reviewing patient safety incidents and how organisations need to come together to identify ways we can support our patient safety teams.

17 “The alarming rate of suicide among healthcare workers should be a wake-up call in the urgent need to support them”

Frontline19 was established at the start of the Covid pandemic as an urgent response to support frontline workers who were under extreme pressure and experiencing significant mental health challenges. In this blog, psychotherapist Claire Goodwin-Fee, founder and CEO of Frontline19, explains how systemic pressures and stigma around mental health are continuing to leave healthcare staff extremely vulnerable.

18 How fostering empathy and psychological safety makes healthcare safer: An interview with Carolyn Cleveland

Carolyn Cleveland has delivered training on empathy and compassion to healthcare organisations for many years. In this interview, she describes how she came to develop her training approach and outlines how creating a psychologically space environment for individuals to engage with the practice of empathy contributes to safer organisational cultures.

19 How to foster psychological safety: Behaviours

Psychological safety is a belief that the group is safe for interpersonal risk taking. There are many ways we can help to foster these environments, but it’s important to remember that we must walk the walk as well as talk the talk! In this article in Psych Safety, Tom Geraghty looks comprehensively at behaviours that build psychological safety and enhance group performance, inclusion, resilience and happiness.

20 What people get wrong about psychological safety

Amy C. Edmondson and Michaela J. Kerrissey describe six misconceptions about psychological safety, explaining why each gets in the way and how to counter it, and then offer a blueprint for building the kind of strong, learning-oriented work environment that is crucial for success in an uncertain world.

21 Beyond “being nice”: What does an effective team really look like?

This article looks at what effective teams actually look like, not just how they feel. It explores why a little tension, when handled well, isn’t a sign of dysfunction but a sign of health. It breaks down how leaders can move from nice-but-ineffective to respectful-and-productive, where debate is welcome, and performance improves because of it.

22 Top 10 ways to foster psychological safety in the workplace

Tom Geraghty shares ten approaches that he's found most effective in fostering psychological safety and enabling people to speak up (and backed up by empirical evidence). 

23 When psychological safety fails, patient safety follows

The NHS has served millions of people over decades. It stands as a symbol of collective care, public service and professional commitment. That history matters. It deserves respect. But patient safety does not rest on history alone. It rests on people. And people need safe systems to do safe work. Today, those systems are under strain in ways that should concern us all. This piece is not about blame. It is about learning, and about starting a conversation that is long overdue.

24 Power and the sound of silence—A blog by Roger Kline

In a review shared on the hub, Roger Kline, Research Fellow at Middlesex University Business School, explored the literature on patient safety and speaking up, arguing that staff being able to raise concerns safely and effectively is essential for patient safety, but the NHS continues to struggle with creating a culture where this happens reliably. In this blog, Roger reflects on some of the findings of his review.

Do you have a resource or an example of how your organisation supports staff psychological safety to share? We’d love to hear about it – leave a comment below or join the hub to share your own post.