The Design for Patient Safety Study showed that the National Health Service (NHS) is seriously out of step with modern thinking and practice with regard to design. The study emphasises the need to move to a user-centred systems approach to designing in healthcare, without which patient safety will remain a significant challenge for the foreseeable future. The development of the MRC/EPSRC/ESRC Design for Patient Safety Network is addressing some of the research issues raised by the need for a systems approach.