The spectacular nature of accidents involving aircraft has obliged the aviation industry to introduce a process of confidential reporting to identify situations that may lead to poor work or even an accident. The information so gathered can then be used to reduce the likelihood of such problems occurring. Confidential reporting allows an individual to bring information relevant to safety to the attention of a body that is completely independent of management. They can be assured that their identity will remain confidential to that body. It is, as far as the individual is concerned, a confidential but not an anonymous procedure, which will be subjected to careful scrutiny. Confidentiality and independence from management are the essential features. The introduction of such a programme into the NHS would materially enhance its safety profile.