This paper aims to develop a conceptual resilience‐based model that takes account of the competing success factors of patient safety, finance, improvement targets and staff workload in NHS hospitals in the UK.
A safe working envelope model was developed from the literature and adapted for use in the NHS. The proposition that finance and targets receive greater management attention was then tested by a pilot study using content analysis of risk management documents of four NHS hospitals.
The need to succeed on finance and targets received greater attention in the risk management documents than patient safety and staff workload.
This is a pilot study only, using content analysis of risk management documents from four hospitals to see whether the model developed from the literature warrants further study.
Using the proposed safe working model will allow the setting and monitoring of failure and marginal boundaries and make more explicit the pressures from the competing success factors in public sector hospitals in the UK.
The development of the conceptual model using ideas from resilience engineering and applying them to NHS hospital management provides a policy and practical approach to improving patient safety.
