The recent alert from the National Patient Safety Agency to implement the World Health Organization’s safer surgery checklist1 is just one element in a far more ambitious campaign to reduce the incidence of avoidable harm and death in the NHS. More than 80% of acute trusts—and a growing number of primary care and mental health trusts—have already signed up to the Patient Safety First campaign since its launch last July. The goal is to “change the culture of the NHS to one that makes the safety of patients the highest priority and makes all avoidable death and harm unacceptable.”

The campaign contains five interventions to reduce avoidable harm (box). But although the WHO checklist is set to become mandatory for theatre staff by February 2010, participation in the rest of the campaign is voluntary. In the place of regulation, the campaign, sponsored by National Patient Safety Agency, the Health Foundation, and the NHS Institute for Innovation and Improvement, builds on the passion of its leaders and their experience of this transformational approach.