Aim To explore the impact of the National Health Service England’s Open and Honest Care Programme on patient safety, patient and staff experience and improvement practices within acute National Health Service settings. Background The Open and Honest Care Programme forms a key tenet of the Nursing Midwifery and Care Staff Strategy launched by the Department of Health in England and Wales in 2012. Methods An electronic survey (n = 387) was administered to National Health Service staff. Semi-structured telephone interviews (n = 13) were conducted with senior nurses and ward managers. Results Over 70% of the survey respondents agreed that the programme increased transparency with the public about the quality of care, helped the working experience of National Health Service staff and improved patient safety respectively. Interviews revealed the Open and Honest Care Programme had enabled National Health Service staff to appraise the effectiveness of their improvement efforts. Conclusion The Open and Honest Care Programme could be an important part of the National Health Service Improvement Strategy. The collection of metric and nar- rative information highlighted where patient-centred improvements were required, facilitating the targeting and development of specific interventions or resources. Implications for nursing management The results indicate that the programme may assist managers to identify areas for improvement and that programmes such as this deserve consideration by health-care management globally.