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The foundational ideas which have informed our thinking are essentially quite simple but hard won in the sense that they are not for the most part embedded in current thinking. We argued that we need to view safety through the patient’s eyes and that safety needs to be approached very differently in the varying settings along the patient journey. This implies in turn that we need to think more explicitly about what kind of safety strategies are most useful in different contexts. We can now draw these themes together and consider the new directions that emerge.

We have put forward a series of arguments culminating in the idea that patient safety should be viewed as the management of risk over time. We have suggested that healthcare could draw on a much wider repertoire of strategies and interventions to manage risk and enhance safety. This has been a book of ideas and argument but we hope that these are both rooted in practice and practical application. In this chapter we first consider some of the more immediate implications as we see them and then consider the form a longer term exploration and development might take.