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Very well said David. It is a sad reality that most doctors, nurses and other staff genuinely want to do their best of their patients but it is our NHS culture, poor leadership which creates corrosive energy and make them what they become. Some still continue to work hard, many become indifferent, many give up and at the end most staff end up as being mediocre. Most of them they care dearly for patient safety and quality but feel helpless and put up with bad behaviour and poor care. We need strong leadership, good culture, where everyone puts patients at the heart and their safety, their care and their wellbeing matters more than anything else and everyone is signed up to that principles and staff feel happy and provide good quality care. Focus on leadership, culture, create an excellent and positive energy, have robust governance and good performance management for everyone in the organisation including all the leaders and managers. Happy staff – happy patients.