Situation Awareness for Everyone (S.A.F.E) Programme

Situation Awareness for Everyone logo - a heart in a green circle

Situation Awareness for Everyone (S.A.F.E) is a two year programme led by the RCPCH which, in partnership with 12 hospitals, is developing and trialling a suite of quality improvement techniques.

Over the course of the two years, it aims to reduce preventable deaths and error occurring in the UK’s paediatric departments – currently there are an estimated 2,000 preventable deaths each year compared to the best performing countries in Western Europe.

The programme will trial models of care including the ‘huddle’ technique - a ten minute free, frank exchange of information between clinical and non-clinical professionals involved in a patient’s care – in a bid to encourage information sharing and to equip professionals with the skills to spot when a child’s condition is deteriorating as well as prevent missed diagnosis.

The huddle technique is one of a number of techniques aimed at improving patient safety, as described by Dr Peter Lachman, S.A.F.E National Clinical Lead, and others involved in the programme in the video below:


Funded as part of the Health Foundation’s Closing the Gap in Patient Safety programme, with additional support from WellChild and UCLPartners, the programme aims to:

  • Reduce avoidable error and harm to acutely sick children by 2016
  • Improve communication between all healthcare professionals involved in a child’s care as well as families to ensure treatment is consistent and of the same high standard regardless of postcode or class
  • Close the disparity in health outcomes for children in UK vs other countries as well as between children’s care and adult care
  • Involve parents, children and young people to be better involved in their children’s/own care

The RCPCH is leading the S.A.F.E Programme on behalf of the S.A.F.E Partnership, which comprises the RCPCH, Great Ormond Street Hospital, UCLPartners, and the Anna Freud Centre.

For programme updates and thoughts on wider aspects of quality improvement, please read the S.A.F.E blog.

Quality improvement

The programme will bring together paediatric units from twelve hospitals from across England into a collaborative, with each running a local quality improvement project aimed at improving outcomes for paediatric patients. While there will be a set of central measures collected, each participating unit has the freedom to focus their project on a particular measure they want to improve.

The collaborative model allows participating units to share their knowledge and experience with other collaborative partners, demonstrating both their successes and failures. This provides the opportunity for good practice to be spread and adapted within the collaborative, and for this to contribute to the single common aim of the programme, to reduce preventable deaths and error from occurring.

Programme evaluation

The Anna Freud Centre is evaluating the impact of improved situation awareness, aiming to answer the question:

Under what circumstances, by what means and in what ways does increasing situation awareness lead to improved safety, experience and other elements of quality for children under inpatient care?

The evaluation will comprise a quantitative element involving all twelve sites, and a qualitative element, which will involve two specialist children’s hospitals and two district and general hospitals.

S.A.F.E Wave 2

Applications for Wave 2 are now closed and we will be making a public announcement to introduce new sites shortly.

Having successfully implemented out the first year of Wave 1, the S.A.F.E Partnership is now looking to extend the project into a second wave. We expect to recruit a maximum of eight additional sites into this wave from all regions of the UK.

The S.A.F.E Programme offers Wave 2 participating sites alternate learning session and action periods through which to build situation awareness into local quality improvement activities. A webinar series will be available to all sites, in addition to site visit support from the project team through the duration of the programme.

S.A.F.E Resource Page

You will find a range of tools and resources developed by the programme team and participating sites of the Situation Awareness for Everyone programme in our resource page. These resources will be added as the programme progresses, and are provided to enable participating sites to learn from others involved in developing quality improvement and patient safety cultures.

Further information

You can keep up to date with the S.A.F.E Programme by following our twitter account, or contacting Darren Cooper (, S.A.F.E Programme Manager.

You can also download and view a short presentation which introduces the programme (PPT, 1.7MB).

The participating hospitals are:

  • Alder Hey Children’s Hospital
  • Birmingham Children’s Hospital
  • Evelina Children’s Hospital
  • Great Ormond Street Hospital
  • Royal Manchester Children’s Hospital
  • Sheffield Children’s Hospital
  • Barts and the London
  • Luton & Dunstable
  • North Middlesex
  • Royal Free
  • Watford General
  • Whittington