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Accountability, fear and public safety

A photo of an operation being carried out
  • How can professional regulation protect the public without undermining efforts to address toxic, fear-based cultures in health and social care?
  • How can we deliver cultural change in frontline care without undermining individual accountability?

These are some of the questions we ask in chapter 4 of Safer care for all. It is vital that workplaces embrace just, learning cultures. At the same time, people need to be accountable for their actions when care has gone wrong, as this helps to keep patients and service users safe from poor practice. Professional regulation is not there to punish, but the public also need to have confidence that serious failures are dealt with – could professional regulation do more to explain its role in keeping people safe so that professionals are not practising in fear of unfair sanction? How can the use of confidential ‘safe spaces’ for learning coexist with candour and accountability? Read Chapter 4 to find out more. 

Find out more

What would you like to read? We have several versions available. You can download:

There is also a Welsh translation available of front part of the report, including The essentials and the executive summary. You can download it here

Please get in touch (via the email address below) with us if you would like a Word version of the full report.

Get in touch

Contact us if you would like to join the discussion about how we can work together to make health and social care safer for all. You can get in touch by emailing