ISO 45001 creates new expectations in the way safety at work is achieved, in part reflecting the way in which work has changed over the years, to this end the new standard is process based and is not dependent on procedures. Other key differences point to the need for proactive leadership in creating the involvement of workers in the process and in considering both the internal and the external context of the organisation before decisions are made about how risks should controlled. The focus on positive outcomes is also enhanced by requiring the organisation to think about ‘opportunity’ (positive) as well as ‘risk’ (negative) when considering where action is needed.