We openly share safety information and focus on learning and improving from incidents, complaints and litigation.

However, we should remember to not only provide feedback about error and harm but to feedback and share information on success and good practice. Safety briefs and huddles are mechanisms through which staff can disseminate learning effectively at local level; staff should be encouraged to use these to foster a learning culture within and between teams.

The Trust is committed to a process of continued review and of transparency and to a programme of focussed continuous professional development for staff. Professional capabilities and behaviours profoundly impact on the patients' experience. The quality of education and training is vital, too often training and e-learning is viewed as a tick box exercise and retention of knowledge from these modalities is poor.

Team based and scenario simulation training is recognised to be effective and well received amongst clinical staff, therefore we should make efforts to expand our simulation training portfolio and to look for learning from adverse events which can be applied to clinical situation teaching and training. We have a commitment to learn and promise to act by using quality improvement methodologies and approaches to design as well as implement pathway and system change. We will use existing frameworks to measure and monitor safety.

The skills and competencies of our staff are key to the delivery of safe, high quality and cost effective care. It is essential that we have sufcient staff to care for the number and acuity of our patients. We recognise that, in particular, numbers of training grade doctors, nurses and non-consultant grade medical staff are low. Constraints remain with regard to the number of training grade medical and nursing staff required nationally.

The Trust is committed to delivering alternatives approaches and investing as required.