Trish Greenhalgh, a leading expert in primary care from Oxford, shares insights from her review on the effectiveness of physician associates in the NHS. Habib Naqvi highlights the ongoing impact of racism in healthcare and the vital need for reform to support ethnic minority patients and professionals. Katie Bramall-Stainer discusses the critical barriers that prevent NHS staff from speaking up, including hierarchical culture and psychological safety issues. Together, they explore solutions to enhance communication and equity in healthcare, making it safer for all.