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Conclusion Various industries have used the 'fresh eyes' concept to identify opportunities to make improvement for a number of years. The Francis report in 2013 stated that JDs are the 'eyes and ears' of the NHS. By recognising that JDs can play a vital role in questioning how things are done, and supporting and empowering them to make improvements, we can not only enhance their engagement and morale but also enable meaningful quality improvement to take place. ■