Patient safety is paramount here. You should also make sure that you back up your answers with examples from your own practice, your specialty, or your local area. For instance, you might say, "Any service improvement would put patient safety first, as well as providing a higher quality and more sustainable service. The change would be clinically led, using evidence based medicine. The service would be tailored to local circumstances using national frameworks. Patients, the public, and staff would be engaged throughout."