In this thought paper, Jane O’Hara and Ruthe Isden consider the role of patients and citizens in the identification of risk and the measurement and monitoring of safety within healthcare.

The paper discusses opportunities for patients, their families and carers, as well as the wider public, to become part of an integrated system for ensuring the safety of care. The authors also consider the challenges and barriers to this involvement, the fundamental paradox of considering the ‘patient perspective’ on safety within the current clinical risk paradigm, and the need for a shift towards valuing the non-clinical voice.