Beatrice Fraenkel is an ergonomist and non-executive director at Stockport NHS Foundation Trust. In this blog, Beatrice shares her reflections on the approach taken to establish a just culture at Mersey Care NHS Foundation Trust during her 14 years as Chair of the organisation. She explores the relationship between culture, leadership, and patient safety, and how one organisation’s journey shows both the power of getting it right and the risks when it begins to unravel. This draws on a presentation Beatrice gave at the Royal Society of Medicine Psychological Safety Conference on 9 June 2026.