Abstract
Most of the current attention on the Health and Social Care Bill is on commissioning, structural changes and competition. Yet there are fundamental new duties for the Secretary of State that will have potential implications for patient safety and quality. The Francis report will add to this renewed attention to patient safety and the risk is that the NHS faces more and more regulation rather than a call for more transformational approaches that may help change the mindset from one that currently continues to ‘accept the unacceptable’ failures that are taking place in our hospitals and other healthcare settings. This article explores the relationship between the traditional governance-based approach and more proactive transformational approaches that utilize improvement science.
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