Knowledge about safety in complex systems are growing and health care is a complex system that is both developing and under pressure. Therefore, patient safety work also has to develop. Basic conditions for safe performance are important: management that values safety, good working conditions, safety culture, adequate staffing and competence, and equipment that facilitates safe practice. Patients and relatives can play a more active role in patient safety work. Safety-II is a valuable new approach to patient safety. The Swedish National Board of Health and Welfare now launches a national action plan for patient safety that addresses these challenges and opportunities.