One of the more delicate steps in encouraging a patient safety culture was taken last week, with the first trust by trust breakdown of safety incident reporting.

This is one league table where it is more difficult than usual to discern who are the heroes and villains. Does high reporting indicate slapdash procedures, or are those with only a few reported incidents failing to admit the truth?

The National Patient Safety Agency believes an organisation with a high reporting rate is far more likely to have high safety standards. It is arguing, in effect, that the only way to get the numbers down is to first get them up.

The campaign to encourage reporting is gaining ground. Two thirds of the incidents did not harm the patient, so staff who could have hushed many of these up have had the courage to come forward. This means managers are succeeding in convincing clinicians they are focused on prevention, not blame.

Leicester City primary care trust clocked up almost nine times the national average for its peers by lifting clinical stones across the city. Two people are employed as reporting evangelists, talking to clinicians about why reporting drives up standards.

But the national serious incident numbers make sobering reading. In the six months covered there were 1,856 fatal incidents and almost double that number caused severe harm.

NHS medical director Sir Bruce Keogh believes safety breaches cost the NHS around£2bn a year. Even halving it would make a significant contribution to recession driven funding cuts.

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