‘A safety culture in healthcare can be thought of as one where staff have positive perceptions of psychological safety, teamwork, and leadership, and feel comfortable discussing errors.’

The Health Foundation

The culture of an organisation influences safety outcomes for patients. Safety culture refers to both the climate among staff and the approach to ensuring patient safety. A first step to enable organisations (or units and departments within an organisation) to improve their safety culture is to understand what the current culture is like for staff working within teams.

The assessment of safety culture is encouraged in high risk industries but is less widespread in health and social care. However a number of different safety culture assessment tools are emerging for use in health and social care, particularly in the acute setting. In this programme, we have road-tested a number of safety climate assessment tools within Primary Care but the learning could be applied to any area of health and social care, whatever tool is being used.


Are you interested in undertaking safety culture work within your team? Have a look at some of the available tools below:

  • Safety Culture Survey – If you are interested in running a safety culture survey in your team, you can contact your Quality Improvement team.
  • The SafeQuest survey, developed by NHS Education for Scotland, was tested in our pilot and, although it was developed for use by primary care in Scotland, it is also available to practices in England as well. Find out more.
  • SCORE (an integrated survey of Safety, Communication, Organisational reliability, Resilience/Burnout and Engagement) is a tool developed by Safe and Reliable Care which was also tested in our pilot. Find out more. 
  • The Manchester Patient Safety Framework (MaPSaF) contains tools for use by acute, ambulance, mental health and primary care teams. Find out more.
  • The Health Foundation evidence scan, Measuring Safety Culture, provides an evaluation of a number of other tools. Find out more
  • Read the Safer Culture report.
  • The Health Foundation – Safety culture: What is it and how do we monitor and measure it? Learning from a roundtable discussion
  • Human Factors and Safety Culture in Healthcare – Salford Royal’s Chief Executive David Dalton and Director of Quality Improvement Siobhan Moran co-authored a paper on human factors and safety culture in healthcare. Read here.
  • The Health Foundation – Does improving safety culture affect patient outcomes?
    Read the research scan here