Patient safety has always been a priority for healthcare organisations. Yet, despite significant investment in governance structures, accreditation, incident management systems, and quality reporting, many leaders still grapple with the same question: how do we know whether our organisation is creating the conditions for safe care before something goes wrong?
The release of the National Model for Clinical Governance 2026 provides an important opportunity for healthcare leaders to rethink how they answer that question. Traditionally, organisations have relied heavily on measures such as incidents, complaints, adverse events, and accreditation results to understand performance. These measures are critical, but they are also retrospective. They tell us where harm has occurred, where systems have failed, or where improvement is needed. What they do not always tell us is whether the culture exists to identify and manage risk before harm occurs. This is why measuring patient safety culture matters.
Moving from hindsight to foresight
One of the most significant shifts in the new Clinical Governance Model is the emphasis on creating the conditions that support safe, high-quality care, rather than focusing solely on responding to quality and safety events after they happen. In many ways, patient safety culture measures provide organisations a window into those conditions. It helps organisations understand questions such as:
- Do staff feel safe to speak up in the moment when they see a risk?
- Are leaders genuinely committed to safety and are they seen that way?
- Do teams learn from mistakes?
- Do employees believe reporting concerns leads to action?
- Is safety embedded in everyday decision-making?
These are not just workforce questions, but also clinical governance questions.
What are we seeing across healthcare organisations at Insync?
Through our work with healthcare organisations, several have emerged consistently in the last three years.
One large healthcare organisation found that while 77% of employees would recommend their service to family or friends, only 58% rated patient safety as “Very Good” or “Excellent.”
In another health service, 72% of employees provided a positive patient safety rating, yet the results revealed ongoing opportunities around organisational learning, leadership visibility and strengthening confidence in safety systems.
What is particularly interesting is that neither organisation would typically be considered a poor performer. In fact, both demonstrated a range of strengths. However, the safety culture data highlighted underlying risks that would have been easy to miss if leaders were relying solely on traditional quality and safety metrics. This is perhaps the most important lesson from our work in patient safety culture measures: risks are often hidden beneath the surface, and viewing patient safety culture as a lead indicator can support proactive decision-making that helps maintain the safety of the healthcare organisation.
Strong teams do not always equal strong systems
Across discussions we have had with our clients over the last two years, teamwork and collaboration consistently emerged as strengths within organisations. Employees frequently reported positive relationships with colleagues, supportive supervisors, and a willingness to raise patient safety concerns within their immediate teams. However, results often became less favourable when staff were asked about leadership at the organisational level.
In one health service, only 31% of staff agreed that hospital management’s actions showed patient safety was a top priority, while just 25% believed management provided adequate resources to improve patient safety in their area.
These findings suggest that many healthcare organisations do not necessarily have a team-level safety issue. Rather, they may have an organisational trust and leadership visibility challenge. For executives and Boards, this matters because the updated National Model for Clinical Governance places significant emphasis on visible leadership, accountability, and creating an environment where quality and safety are clearly prioritised.
The role of psychological safety
One of the strongest predictors of a healthy patient safety culture is staff psychological safety. When clinicians, support staff and leaders feel comfortable raising concerns, challenging decisions and discussing mistakes, organisations gain access to valuable information about risk. When people do not feel safe speaking up, risks often remain hidden until they appear as incidents, complaints, or adverse outcomes.
For this reason, psychological safety should not be viewed as a workforce initiative alone; it is a patient safety strategy. Boards and executive teams have invested heavily in systems to manage risk. Those systems are most effective when people feel safe enough to use them.
The warning signs leaders often miss
One of the most powerful aspects of patient safety culture data is its ability to identify emerging risks before they appear in incident reports.
We have seen organisations where fewer than half of staff agreed that safety incidents were regularly discussed within their teams, corrected mistakes were consistently reported, or that the organisation effectively learned from safety events. None of these measures represents patient harm in themselves. Instead, they point to weaknesses in the behaviours, communication practices, and organisational systems that help prevent harm. By the time these issues appear in incident data, the opportunity for early intervention has often passed.
Incident reporting is not the same as organisational learning
Another theme we see regularly is that organisations are often strong at encouraging incident reporting, but less effective at closing the loop. Staff generally understand how to report a concern. They are less certain whether reporting results in meaningful change. We continue to see opportunities to strengthen communication about lessons learned, organisational responsiveness, and continuous improvement following safety events.
The question for leaders is no longer: “Do we have a reporting system?”
The question is: “Do our people believe the reporting system leads to improvement?”
The difference may seem subtle, but it is significant.
Why this matters now
The National Model for Clinical Governance 2026 reinforces the importance of leadership, learning systems, workforce capability and organisational culture. Patient safety culture sits at the centre of each of these foundations. It helps leaders understand whether:
- Leadership behaviours are supporting safety
- Staff feel safe to raise concerns
- Improvement systems are functioning effectively
- Learning is occurring following incidents
- The organisation is fostering a just culture rather than a blame culture
More importantly, it provides insight into areas that are often difficult to measure using traditional quality metrics.
One way to consider patient safety, we believe, is to reflect on this question: If your incident rates remained stable over the next 12 months, but only one-third of your workforce believed leadership genuinely prioritised patient safety, would you still feel confident that your organisation was safe?
Looking beyond what has happened
The National Model for Clinical Governance challenges healthcare organisations to look beyond whether governance systems exist and ask whether those systems are creating the conditions for safe care. Our experience suggests that most healthcare organisations already have many of the right processes in place. The question is whether staff experience those processes as intended. Patient safety culture data helps answer that question by highlighting where harm may occur next. In an environment where Boards and executive teams are increasingly expected to anticipate and manage risk, staff experience of patient safety culture is an important distinction.
Learn more today
Contact us to discuss how patient safety culture insights can help you identify risks earlier and strengthen clinical governance.
