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.

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.

I’m Liam, a Specialist Clinical Pharmacist in Acute and Emergency Care at Northumbria Healthcare NHS Foundation Trust. I split my time between clinical practice (four days a week) and research (one day a week) through the NIHR Newcastle PSRC Patient Safety Development Award. Since graduating from Newcastle University’s School of Pharmacy in 2022, I’ve been building my research career alongside clinical development, driven by a passion for research sparked during my undergraduate studies.

Traditionally, clinical practice and academia have been seen as separate career paths. Clinicians interested in research often had to pursue it in their own time, outside of demanding full-time roles.

The NIHR clinical academic pathway has transformed this by funding protected research time and reimbursing employers, allowing clinicians to step away from practice to pursue research.

For me, this has meant one day each week seconded at NIHR Newcastle PSRC, where I’ve developed core research skills. Working with experienced researchers has helped me understand the full project lifecycle, from shaping early ideas and designing methodology to recruiting participants, collecting data, and writing up results.

Embedding clinicians within the NIHR Newcastle PSRC helps build strong links with partner organisations. Connections with charities and local health and social care providers create future opportunities at both individual and organisational levels. This also broadens the chance for under-represented groups to have a voice, influence practice, and help reduce health inequalities.

At Newcastle University, embedded clinicians benefit from access to leading academics in their field and can learn from their experience. Previously, collaborations were often ad hoc, such as draft reviews or methodology advice. These awards now enable clinicians to work more closely with academics and gain a deeper understanding of research and academia.

Research-active organisations are linked to better patient outcomes. Combining clinical work with research lets me address real issues I encounter in practice, shaping projects that can drive meaningful change.

In acute medicine, I’ve focused on discharge and follow-up challenges. Through the NIHR Newcastle PSRC, I’m now working on a project exploring these issues for homecare recipients and those working in the industry.

Being embedded in both sectors also helps spread research findings more effectively, supporting better service improvements and outcomes.

A key goal is to encourage more healthcare professionals to engage in research. The NIHR clinical academic pathway supports this by offering development alongside clinical roles, leading to qualifications and national research leadership opportunities.