I went to the NIHR SafetyNet Organisational Culture working group meeting in Birmingham on a cold day in January. I wanted to learn what “organisational culture” means and how it links to patient safety.

So, what is organisational culture?
After listening to researchers from different PSRCs, I learned that organisational culture is basically how people at work get along. It includes the relationships between colleagues, managers, departments, services and different job roles.

How does this affect patient safety?
The way people treat each other at work can directly affect the care patients receive. If communication and relationships between teams are poor, things can go wrong.
For example:

1. A patient might be sent home from hospital, but no one tells their family or carers, so no one is there to meet them.
3. A family may still be waiting for a call to say they can collect their loved one, only to find out the patient has already been taken home by hospital transport.

But when communication and teamwork are good, patients get much better care.
For example:

1. Maternity staff might tell new mothers about breastfeeding support available in their community.
3. If an older person is having surgery, hospital staff may work with community care teams and family members to plan what help the patient will need at home.

The biggest thing I learned

If staff are unhappy, feel unappreciated, experience bullied, or feel insecure in their jobs, this can lead to poor communication and bad relationships at work. This can then cause poor-quality services, lower standards of care, and higher risks to patient safety.

But if staff feel happy, valued, and supported, they are more likely to work well together. Good relationships between teams mean better services, higher standards of care, and safer experiences for patients.

Dr Matthew Cooper, NIHR Newcastle PSRC Safer Integrated Health and Social Care Environments, Research Associate

Broadening My Understanding of Organisational Culture

Attending the organisational culture working group helped me to broaden my understanding of what organisational culture truly represents. Initially, I viewed workplace culture mainly in terms of supporting staff wellbeing and keeping people happy and healthy at work. Through the discussions, I realised how strongly organisational culture also influences patient safety and the consistent delivery of high-quality care.

Exploring the Ambition of the 10‑Year Plan

The working group explored the ambition of the 10-year plan, which is expected to drive change both during the next 10 years and for the future beyond. This however highlights some key risks:

• That pressure to deliver quickly could lead to rushed decisions,
• Missed input from some disciplines (implementation science for example), or
• Action being taken without full consideration of the plausible impacts (for example removing resources from one service to fund a new idea).

A strong emphasis was placed on transparency of quality of care, including empowering patients through greater voice, choice and access to information. This was balanced alongside clearer accountability and stronger incentives for high-quality care. I was particularly struck by the challenge of double running costs, where services must continue to operate while resources are reallocated, and the importance of deliberately creating time for safety within this context.

Reaffirming the Core Purpose of Organisational Culture

Overall, the working group reinforced that the core goal of organisational culture is to support patients, underpinned by robust checks and balances, compassionate leadership, and a shared commitment to quality and safety at every level of the system. As a team at the NIHR Newcastle PSRC, this is something we are all hoping to reflect on and take forward in our research.

Learn more about the NIHR 10 year plan.

I was grateful to travel to London for the PSYCH Symposium 2025 on Thursday, 4^th December. This symposium brings together researchers, therapists, doctors, policymakers, investors, and campaigners to talk about the latest research in psychedelic medicine and how psychedelic therapies may be used in mainstream healthcare to treat mental health conditions.

I attended the symposium with Radin Karimi, another PhD student from the NIHR Newcastle Patient Safety Research Collaboration (PSRC). Like my own work, Radin’s research looks at how to better manage polypharmacy (which is when people take many different medicines at the same time). Medicines used to treat mental health conditions often add to this problem, so we were interested to find out if psychedelic therapies might help people manage their mental health so they can take fewer medicines. We were also keen to learn how patient safety is managed in this developing area of research.

The symposium focused on a range of conditions, including depression, anxiety, PTSD, addiction, eating disorders and distress near the end of life, particularly for people who have not responded to more commonly used treatments. Speakers shared evidence showing that psychedelic medicine, such as psilocybin, MDMA and ibogaine, can help to ease symptoms in people with these conditions. They also explained that psychedelic therapies may help people process deeper emotional problems behind their symptoms, which can lead to longer-lasting improvements in well-being. Several speakers had worked with military veterans and shared how these therapies have helped them manage PTSD, support their mental health, and feel better in everyday life after leaving the military.

Patient safety was a major focus throughout the symposium. Research in this area is strictly regulated, with people being carefully checked (called screening) before they’re invited to take part, and with study information being clearly explained so that people can make an informed choice when agreeing to join a study. Therapies are provided in carefully controlled and supportive treatment spaces by highly trained therapists and healthcare professionals, with close monitoring during sessions, and follow-up support after the treatment to help people understand their experiences and get the best results from the treatment.

Professors David Nutt and Guy Goodwin had an interesting discussion about recent results from a large study which showed that a single dose of synthetic psilocybin helped people with severe, long-lasting depression, with higher doses leading to bigger improvements in symptoms. They also spoke about drug laws creating stigma around psychedelic research, even though there is growing evidence that these substances can have real health benefits and that they may be less harmful than legal drugs, such as alcohol and tobacco.

One example of how psychedelic medicine is being used in standard healthcare came from Professor Ranil Gunewardene, who described how he is leading one of the first clinics in Australia to offer regulated psychedelic-assisted therapy. Since his research is with patients who have complex health conditions (called real-world patients), it may give us helpful insight into how these therapies can be used outside of highly controlled research environments.

In summary, the symposium showed that psychedelic medicine has promising potential to improve care for people with mental health conditions, particularly those that are difficult to treat. It also highlighted that more research is needed and that building upon the current evidence base will help us better understand how effective and safe these treatments are, and how they can be carefully and appropriately used as part of standard healthcare.

Details and bios for each of the speakers can be found here

Yahya F, Cooper M, Saif W, Kassem M, Nazar H Development of a Hospital at Home Digital Twin for Patients With Frailty: Scoping Review Journal of Medical Internet Research 2025;0:e0 URL: https://www.jmir.org/2025/1/e81510 doi: 10.2196/81510

How can we make the most of advanced technology and live information to improve how we deliver hospital-level care at home?

Why are we looking at this?

The NHS 10-year plan wants to:

• Move more care from hospitals closer to home
• Prevent illness instead of just treating it
• Use more digital tools to support care

• Technology and real-time data can help health professionals care for patients at home more efficiently.
• Digital Twins could make care timelier, safer, and tailored to each person.
• We’ve outlined the main building blocks for creating a Hospital at Home Digital Twin.

This work is just the beginning, but it shows how technology could possibly change the world of healthcare and what needs to be worked on to make this possible.

Our article reviews the current evidence for tools that exist to support the development of a Hospital at Home Digital Twin. We describe the 5 layers required to build a Digital Twin. Results show that a variety of technologies exist to pick up information, such as wearables. However more understanding is needed of how we manage that data, store it, translate it and use it to make useful predictions to help staff who are looking after us make decisions. This article also talks about some of the challenges and opportunities we may face when using these technologies in our current healthcare system.

Steve discussed several barriers for patients accessing care, such as language and language style, communication that isn’t just about language (e.g., neurodiversity, sensory needs, memory, processing speed), physical disability, diagnostic overshadowing and hypersensitivity (e.g., to sensory stimuli, environments, noise, smells). These may mean that reasonable adjustments to consultations are used; for example, longer appointment times, quieter environments, visual prompts, alternative formats, consultation breaks or bringing a support person to accompany.

Steve shared with us some very impactful real-life examples of people he has provided care for who have required reasonable adjustments, and demonstrated what it means to go the extra mile in delivering person-centred care.

He summarised that reasonable adjustments are not something necessarily taught within university or professional training but are central within professional capability. Being aware of additional needs, asking patients what they would prefer and anticipating barriers and how to act on them allows us to demonstrate humility and advocate for the best possible outcomes for our patients.

It was a very stimulating and thought-provoking session, and it was great to see a big audience of attendees, spanning undergraduate Pharmacy students, postgraduate students, members of the NIHR Newcastle PSRC, wider University network and clinical colleagues from Newcastle upon Tyne Hospital NHS Foundation Trust.  The talk provided valuable insights that we can apply not only in our current roles but also take with us throughout our future careers. Engaging with reasonable adjustments in consultation settings may allow us to be better equipped to promote person-centred care to diverse, underrepresented patient groups.

Thank you, Steve!

Equity cannot exist without disability inclusion. This month, as we mark UK Disability History Month, I want to pause and reflect on what inclusion really means, beyond statements, beyond awareness posts and beyond checkboxes on institutional forms.

Disability is not a niche issue. It is a public health issue.

It is a human rights issue.

It is a societal responsibility.

Disability history reminds us that progress did not happen by accident. It came from disabled activists demanding better-from accessible transport to inclusive education, to rights-based healthcare. Their work continues today, and we owe it to them to keep pushing.

Across the world, disabled people continue to face overlapping barriers such as inaccessible healthcare, limited education and employment opportunities and stigma that is often disabling than the condition itself. Out of the barriers they face, the most difficult one which sits uncomfortably at the intersection of public health, ethics and disability rights is the emergence of measures that subtly suggest a final option when what is most urgently needed is meaningful prioritisation, adequate resourcing, and sustained approaches that uphold the value of their lives.

True accessibility is not an afterthought. It is a starting point. It asks us to design spaces, policies and services that recognise disability as a natural part of human diversity, not an exception or burden to accommodate. The answer to our questions must always be better care.

This month, I hope we move from awareness to action.

From support to taking accountability.

From Inclusion to redesign.

Because a society that works for disabled people works better for everyone.

To all disabled students, staff, parents, carers and community members- your presence strengthens the world, your voices reshape our understanding, and your contributions enrich our collective future.

Let’s honour Disability History Month not just by remembering the past, but by reshaping the future together.

On 17th October 2025, I was very excited to present my research poster at the NIHR SafetyNet Symposium in Manchester. SafetyNet is a group of six NIHR Patient Safety Research Collaborations (PSRCs) across England. This year’s event had a special theme: “Tackling Inequities in Patient Safety.” It was the first time to bring together researchers, doctors, and patient representatives from across the country to share ideas and thoughts.

The symposium included inspiring talks, research showcases, discussions, and poster sessions. I was especially interested in two keynote talks, one about moving away from a “blame culture” in healthcare, and another about ethnic inequalities in patient safety.
I also learned about many areas I had never thought deeply about before, such as healthcare harms in prisons, inequality in perioperative and respiratory care, and access to medicines for people experiencing homelessness.

These sessions made me realise that inequality in health is a very complex issue. It is shaped by factors like race, social background, environment, and language, and also by how society responds to unfairness itself. These issues are linked together, often trapping those already at a disadvantage. To change this, what we can do is to build a strong “safety net” that supports everyone, especially people who are underrepresented or face extra barriers.

My poster was titled “Predicting Diabetic Eye Disease with AI: Trajectory Embedding and Causal Exploration of Statin Effects.” In simple terms, my study looked at how artificial intelligence (AI) can help predict who might develop diabetic eye disease, a leading cause of sight loss in people with diabetes. I also explored whether statins, common cholesterol-lowering medicines, can help reduce this risk. In addition, we found that there are inequalities between males and females, and among diabetes types. These results suggest that healthcare can be more personalised and fairer for each person.

Attending this symposium was a great experience. I met many passionate researchers who share the same goal: to make healthcare safer and more equal. It reminded me that technology like AI should not only make predictions but also help reduce health inequalities and improve care for everyone.

One reflection that stayed with me came from a discussion about adoption and breaking cycles of poverty and violence. Even in systems that often feel broken, there are ways to create safety and opportunity through compassion and action.

In August I was lucky enough to have the opportunity to travel to Singapore to attend the BMJ International Forum on Quality and Safety in Healthcare. I presented a poster about a service evaluation I had worked on, led by Dr Matt Cooper, which explored a hospital discharge service providing one-to-one, personalised support for carers of people leaving hospital.

The conference theme, moving together toward sustainable quality, emphasised the importance of collaboration across sectors to achieve lasting improvements in healthcare. Many sessions focused on involving patients and carers as partners in care, by embedding lived experience into service design and evaluation to make change meaningful and sustainable. Other sessions explored how to support population health across the life course, recognising the social factors that shape health and the role of community-based care.

These messages echoed the key findings from our service evaluation, which highlighted how person-centred, inclusive support can empower carers to support their own wellbeing and the patient during hospital-to-home transitions. Our approach of working with staff and carers to understand the service’s impact reflected the same emphasis on participation and learning that was central to the conference. For me, a key message was that sustainability in healthcare also depends on continuity, where good care extends beyond the hospital to meet people’s needs in the community.

After the conference I got to explore Singapore and think about sustainability in a different way. The contrast between greenery and skyscrapers, the hawker centres blending food from diverse communities together, and the evening light show through the Supertrees were all incredible reminders the benefits of collaborative design.