Patient safety incidents have physical and emotional consequences for those involved, including patients, carers, relatives and healthcare staff. This article, the fifth of seven in this series, focuses on Step Five of the Seven Steps to Patient Safety (National Patient Safety Agency (NPSA) 2004): involve and communicate with patients and the public. The article discusses how to communicate with patients and their carers who have been involved in a patient safety incident that led to moderate harm, severe harm or death.