Creating a Director of Patient Safety role: a valuable opportunity

Summary

Deborah Dover is an NHS Consultant Child and Adolescent Psychiatrist, a Topic leader for the hub, and a Director of Patient Safety. In this blog, she tells us more about the Patient Safety Director role and how it can be a powerful driver for safety improvement.

Content

When I joined East London NHS Foundation Trust (ELFT) as their first Director of Patient Safety, I quickly discovered that people were curious about what the job actually involves. Safety is something we all care deeply about, but the work behind building safer systems can sometimes feel hidden in the background. So, I wanted to share a little about what the role looks like in practice, why it matters, and how we’re trying to shape a more proactive and connected approach to safety across the organisation.

Why the role matters

Healthcare is delivered in busy, complex environments, and even with talented, committed teams and individuals, NHS systems often are far from reliable, and variation is commonplace. Safety science and systems thinking can really help us understand how to create safer and more resilient care. But historically most clinicians and leaders haven’t had formal training in these areas, and often the work of designing for safety isn’t owned by anyone at senior level.

That’s where a dedicated leadership role can make a difference. Safety becomes much more than responding to incidents — it becomes something deliberately designed, coordinated and supported across the whole organisation.

My path to the role

I became the trust’s Director of Patient Safety in 2022 after several years in a neighbouring trust, supporting safety and improvement as a Deputy Medical Director and Associate Medical Director for Quality Improvement. As part of my induction, I attended the Institute for Healthcare Improvement’s Executive Patient Safety programme. Seeing how common Chief Safety Officer roles are in US healthcare, made me realise the opportunity there is for the NHS to go further in benefitting from senior, specialist leadership for safety.  

The role and its purpose

Before I joined ELFT, the trust had undertaken an external review of patient safety, led by safety expert, Professor Carl Macrae. One of his recommendations was to introduce a board level role to take a more coordinated approach to safety. That review gave us a strong starting point to build from and using it as a foundation, I led the co design of an ambitious whole trust Safety Plan.  

The plan brings together work on patient safety, workforce safety and upstream, population level factors that influence safety. It’s built on a few important ideas: that equity and safety are inseparable; that patients and carers bring expertise we must include and that a compassionate, just culture underpins reliable care. There is also recognition of the importance of learning from all outcomes, not only when things go wrong and that safety systems must be future focussed, using intelligence to problem-sense, anticipate safety risks and respond to issues in a nimble way.

Nationally, the introduction of the Patient Safety Incident Response Framework (PSIRF) has been a helpful enabler. It has supported our ongoing journey to ensure positive safety cultures, move toward systems thinking and forward-looking learning, and to involve patients and carers.  Alongside this, we’ve been working on strengthening our focus on reliability, measurement for learning and anticipating risks early.

What difference does a Director of Patient Safety make?

Having a dedicated safety director is helping us bring clarity, focus and alignment to safety work across the trust. It has strengthened the links between safety, improvement, workforce wellbeing and population health and has supported us to build capability in safety science, so teams have what they need to improve.

We now have a strong network of Patient Safety Specialists across services, alongside an in-house Lead Patient Safety Partner who brings her own lived experience and coordinates further service user involvement into our safety systems.  Our online Safety Learning and Training Hub is making safety knowledge more accessible to all, with systems thinking also now woven into our leadership and improvement programmes. We are continuing to strengthen our approach to just and equitable culture, and are working to improve how we support both staff and service users after safety events.

Recently we’ve begun collaborative research, learning from the way our safety system works, and how we can go further to integrate the key aspects within our Quality Management System to support proactive, whole system safety.  We are also increasing our focus on population level safety insights and social determinants of safety outcomes, in line with our ambition for whole community safety.

Our aim of safer care, safer people and safer lives across our communities is supported through all of this work.

A call to action

For organisations thinking about creating a Director of Patient Safety role, I would strongly encourage taking that step. As Ted Baker, Chair of HSSIB, recently said: “Safety is not just one of the domains of quality. It is the foundation on which other aspects of quality are built.”

If safety is foundational, senior leadership for safety must be too. 

About the Author

Deborah Dover is an NHS Director of Patient Safety, Patient Safety Specialist and Consultant Child and Adolescent Psychiatrist. She has previously served as a CAMHS Transformation Lead, Suicide Prevention Lead, Named Doctor for Safeguarding Children, Associate Medical Director for Quality Improvement and Deputy Medical Director. She now leads ELFT’s five year Safety Plan, focused on culture, systems, learning and improvement.