In the wake of the Francis report, the need for NHS trusts and hospitals to adopt a culture of learning, safety and transparency has been highlighted. This article considers different aspects of culture in health care, and hones in on the link between culture and safety for patients in putting the patient first, embedding the 6Cs and considering the options to measure and influence organisational culture. The article reflects more deeply on how leadership across all levels can influence and inspire change in organisational culture, ensuring that the patient remains the focus of any changes in care delivery.

Ann Muls - Macmillan Nurse Consultant GI Consequences of Cancer Treatment, Royal Marsden Hospital, London

Lisa Dougherty - Nurse Consultant (IV therapy), Royal Marsden NHS Foundation Trust, London

Natalie Doyle - Nurse Consultant (Living with and beyond cancer), Royal Marsden NHS Foundation Trust, London

Clare Shaw - Consultant Dietitian, Royal Marsden NHS Foundation Trust, London

Louise Soanes - Teenage Cancer Trust Nurse Consultant for Adolescents and Young Adults, Royal Marsden NHS Foundation Trust, London

Anna-Marie Stevens - Macmillan Nurse Consultant (Palliative care); Royal Marsden NHS Foundation Trust, London