Four and a half years ago, the Patient Safety Management Network (PSMN) began in the simplest of ways: just four people on a Teams call.

The new Patient Safety Incident Response Framework (PSIRF) was emerging, and each of us were trying to make sense of what it meant in practice. We weren’t looking for anything grand - just a space to connect, to share a little peer support, and to avoid feeling quite so alone in the work we do.

Nervous beginnings

Looking back now, it’s almost comical that we chose to hold our first meetings on a Friday afternoon. In retrospect, it sounds ridiculous - how was that sustainable? Why would anyone willingly show up at the end of the week, when energy is lowest and inboxes are fullest?

And yet, people did. Perhaps it was the timing, coming at the moment when we were finally exhaling from the week. Perhaps it was the relief of finding others who were facing the same uncertainties. Whatever the reason, those early Friday sessions became the unlikely seedbed of what the PSMN would become.

At first, even sharing the smallest thing - like a template - made us nervous. Did we even have permission from our organisations to share this?

Every exchange carried a sense of caution. Some people were unsure if they were ‘allowed’ to join the meeting without permission. The network was transactional, useful, but tentative.

From transactions to connections

In those earliest meetings, the structure was simple. The majority of the time was spent with one person “teaching” the group something, it may have been about the role of the Academic Health Science Network or an update on the Patient Safety Incident Framework. It was mostly passive - people listened, a few had cameras on, but there wasn’t much interaction.

And that was okay.

The purpose back then wasn’t to force participation. It was to listen, share, and simply be present. If “being present” meant sitting quietly with your camera off, that was absolutely fine. People didn’t have to be there. The fact that they showed up - on a Friday afternoon no less - was the first sign that this network mattered.

Presence became the foundation. Even in silence, people began to sense that they were not alone in their work, their questions, or their uncertainties.

Over time, that quiet presence grew into participation. People began asking questions, adding their experiences, and opening up. The dynamic shifted from one-way teaching to two-way learning, and eventually into rich, many-to-many conversations where every perspective mattered.

That was the turning point: the realisation that the PSMN wasn’t just about transmitting knowledge - it was about creating it together.

Building psychological safety

This deeper sharing required something crucial: psychological safety. Trust that questions wouldn’t be dismissed. Trust that missteps could be talked about without fear. Trust that every voice mattered, regardless of experience or role.

Over time, members began modelling openness and vulnerability - admitting when they didn’t know the answer, sharing stories of what hadn’t worked, and inviting others to join them in learning.

Bit by bit, the culture evolved into one where curiosity was celebrated, not questioned.

A platform for shared learning

Today, the PSMN is unrecognisable from those early Friday calls. It has become a psychologically safe learning platform where insights are not just exchanged but created together.

What makes it truly special is the breadth of the community. The network brings together voices from every corner of the healthcare system - frontline staff from all sectors, Patient Safety Partners, carers, academics, commissioners, regulators, and more. You name it, the expertise is represented within our network. And that mix of perspectives is powerful.

Because here, learning isn’t confined by organisational walls, geographical borders, or professional silos. Instead, knowledge flows freely across them. Each conversation is enriched by the fact that people are willing to step outside of their own context and learn from others.

Now, the PSMN is moving into something we could only have dreamed of in those early days: sharing our Patient Safety Incident Investigations.

To begin with, this means exploring how we are approaching them and what the learning has been. It’s an incredibly exciting step - because this is the first time in patient safety history that this kind of open sharing has been done.

It is a sign of just how far the network has come: from tentative, nervous beginnings to breaking new ground in the way patient safety is learned and shared.

Looking back, looking ahead

When we reflect on this journey - from four people on a Friday afternoon call, hesitant to even share a template, to a thriving community that spans the entire UK healthcare system - it’s hard not to feel anything other than inspired.

What started small, simple, and a little uncertain has grown into something transformational.

The PSMN has become a beacon of what is possible when people come together with openness, trust, and courage. It is no longer just a community of interest, it’s an emerging movement 

Want to join us?

Does your work involve Patient Safety? Are you based in the UK? Would you like to be part of this journey - learning, sharing, and shaping the future of patient safety together?

Join the PSMN via the Patient Safety Learning hub

The more voices we bring together, the stronger our collective learning becomes.

1. Respect and feeling valued
2. Positive identity
3. Wellbeing
4. Raising concerns & speaking up
5. Placement induction
6. Communication
7. Flexibility
8. Supervision
9. Teaching and learning needs
10. Time and space for learning.

The SLEC priorities and solutions present clearly to education and placement providers, assessors, supervisors and learners, as well as others working in the health and care system, what must underpin the culture of our learning environments. 

The SLEC is written for the use of education and placement providers, assessors, supervisors and learners, however it must be actioned by everyone, everywhere, every day and the behaviours and principles embedded into our culture.

Equality, diversity and inclusion (EDI) and patient safety is the golden thread that runs through the SLEC Charter.

• C : First, state your concern.
• U: Then, state why you are uncomfortable.
• S: If the conflict is not resolved, state that there is a safety issue. Discuss in what way the concern is related to safety. If the safety issue is not acknowledged, a supervisor should be notified.

You can watch an example of the use of CUS. 

CUS is also a recommended tool to express concerns regarding the need for a medical interpreter when conversations involve patients with limited English proficiency.

A video-based example of using CUS for this purpose is available.

Reflective practice is the process that you can go through to engage in thoughtful and purposeful consideration of the experiences you have had, the actions you have taken and the outcomes of those actions. It involves a conscious effort to gain insights, learn from experiences and enhance your professional and personal development. Reflective practice is used in various fields but is used a lot by healthcare professionals to analyse patient interactions, clinical decisions and the overall delivery of healthcare interventions.

To be able to engage in reflective practice it is important to understand your own thoughts, feelings and reactions to different situations. An open and honest mindset is key to achieving this. The ability and willingness to consider different perspectives is important – to challenge assumptions, your own and those of others. Your coach should encourage you to analyse and evaluate experiences, actions and decisions to identify strengths, weaknesses and areas for improvement.

Part of the reflective learning process is viewing experiences as opportunities for learning and growth and actively seeking ways to expand your knowledge and improve your skills.

During my tenure at AfPP a colleague introduced me to a book called ‘The Three Minute Diary’. The diary provides you with an opportunity to reflect on your day and document experiences that in turn facilitates the reflection process. It asks what has been good in your day, what has been bad, what you were grateful for, etc. I found it invaluable, and I still dip into it when my pathway has become a little blurred and I need clarity.

From experience I know that it is very easy to walk away from a fiery or difficult situation and think about what you should have said. I call this the ‘if only’ scenario. If only I had said that. In the heat of the moment, we often forget to breath which in turn stops us thinking and behaving effectively.

Reflection isn’t only about thinking about what we should have said but also about enhancing our ability to identify and address challenges through thoughtful and clear analysis of the situation, which often provides you with alternative solutions.

It can deepen our awareness of personal values, beliefs and strengths and also our areas of improvement. This will support our ongoing learning and development, which contributes to our professional competence and effectiveness; resulting in heightened empathy and understanding of the perspectives of others, which can lead to improved interpersonal relationships both at work and at home.

We all want to be good decision makers and reflective practice can encourage us to review the decisions we have made and, in the future, consider the potential consequences and ethical implications of the choices you make.

Reflection supports continuous improvement in work or practice by identifying and addressing areas that can be refined. It aids personal growth, self-discovery and achieving any life goals you have set for yourself.

Reflective practice is dynamic and an ongoing process that contributes to continuous learning and improvement, fostering a mindset of curiosity, openness and adaptability.

The bottom line is that with coaching, people can become better at what they do and in a healthcare setting that is so very important to the safety of the patients.

Coaching is a very undervalued business tool that can be important to any professional no matter where they are in their career. Great athletes at the top of their game have a coach. Brilliant singers have voice coaches to keep them hitting the right note. We all reach our limits and are unable to improve because of the complexity of things going on around us – an external pair of eyes can help us focus on the blurred edges and help us to continue seeing the bigger picture.

However, we do have to feel safe in our environment to be able to speak openly and offer support and guidance to people who don’t always want it. Psychological safety is a shared belief that the environment is safe for interpersonal risk taking. 

It’s tough at the top and it’s tough to be a patient – so you should invest in yourself to ensure patients are kept safe. It’s not about how good you are right now, it is about how good you can be, or are going to be that really matters.

Any improvement, big or small, can impact greatly on patient safety and healthcare outcomes. 

Further blogs from Dawn:

• To coach or not to coach? Part 1
• To coach or not to coach? Part 2
• Developing cultural change in healthcare: Part 1
• Developing cultural change in healthcare: Part 2

Coaching can often make sense of the chaos around us – we don’t bring our best self to the table when we are functioning under stressful circumstances.

Inner self-empowerment through coaching involves helping individuals tap into their inner resources, their strengths and potential to overcome challenges, achieve goals and live a more fulfilling life.

It is a personal strength to be able to reflect on a given situation, previous behaviours and improvements for the future. In healthcare, professionals can be asked to act as a mentor or coach for a new member of the team or an apprentice working in the department. For any coach, recognising improvements in the abilities of others and their skills can be subjective and the signs may vary depending on the nature of the skill or activity. Some common indicators that someone has improved could be:

• A consistency in their performance and delivering high-quality work or positive results is a good sign of improvement. Especially if it is benchmarked against a starting point.
• As individuals become more skilled, they tend to perform tasks more efficiently. Improved efficiency may include completing tasks in less time, using few resources or achieving better outcomes with the same amount of effort.
• Confidence tends to grow as skills improve. As a coach you may notice your mentee becoming more assured in their abilities and it may be an indication that they have become proficient in the task.
• With improved skills often comes adaptability. Someone who has improved at their core tasks may demonstrate a greater flexibility and improved problem-solving skills.
• If mentors, peers or supervisors are providing positive feedback it suggests that the mentee’s skills have advanced.
• Continued learning and commitment to personal development are indicators of improvement. Someone who actively seeks new knowledge, embraces challenges, and learns from experience is likely to have improved over time.
• Depending on the nature of the skill, measurable improvements can be a straightforward indicator. 
• Advanced skills often lead to innovative thinking. If someone starts to come up with creative solutions, introduce new ideas or contribute to the improvement of processes, it is a sure sign of growth in their abilities.

Improvement is a gradual process and different skills may manifest progress in various ways. Additionally, it is essential to consider the context and specific criteria relevant to the skills in question.

If you the coach encourage kindness, it is a prosocial behaviour that can benefit society as a whole. These behaviours are often characterised by selflessness, co-operation and a concern for the wellbeing of others. Prosocial behaviours can manifest in various ways and in different contexts, which include:

• Kindness and courtesy: behaving in a considerate and polite manner towards others, promoting positive interactions in various settings.
• Helping others: assisting someone in need.
• Sharing and co-operation: pooling resources, information or skills with others and working collaboratively towards a common goal. Leaving your ego at the door and knowing that a joint success is as important as you achieving something alone.
• Empathy and compassion: understanding and sharing the feelings of others and showing compassion in response to their needs or challenges.
• Altruism: engaging in actions solely for the benefit of others, even when there is no apparent personal benefit.
• Conflict resolution: using communication and problem-solving skills to address conflicts in a constructive and non-aggressive manner.

It is safe to say that coaching can play a strong role in fostering prosocial behaviours by building self-awareness. A coach has the gift to help individuals understand their values, beliefs and the impact of their actions on others. By providing individuals with different perspectives, the coach can encourage individuals to develop an empathetic approach to given situations.

In my career journey, I have spent a lot of time with different types of people, working in different environments, latterly and mostly in healthcare settings. I have been fortunate enough to develop training packages, deliver training, encourage change and manage complex strategies in support of patient safety initiatives. Every time I ask the same question to different teams at all levels of the career spectrum – "how good is your communication?" I would say that 80–90% of people would say their communication was good but that of other’s was not as good as theirs.

We have a pre-conceived idea that we are great communicators, but the reality is that we are not. We can always improve and for a coach to help strengthen the communication skills of an individual is one of the most important elements within their role. Promoting active listening to enhance interpersonal relationships is a key fundamental of good communication.

Goal setting is key to coaching, giving the mentee tasks as part of the coaching programme is important and if the coach can assist individuals in defining and working towards goals that contribute to the well-being of others or society, that is a great achievement.

Ultimately, coaching for prosocial behaviour involves guiding individuals towards a mindset and behaviours that contribute positively to their social environment and the well-being of others around them. Supporting individuals to cultivate a growth mindset and promoting the belief that they can develop and improve themselves through effort and learning is crucial.

In part three, Dawn will discuss the importance of reflective practice and how it can be used to analyse patient interactions, clinical decisions and the overall delivery of healthcare interventions.

Further blogs from Dawn:

• To coach or not to coach? Part 1
• Developing cultural change in healthcare: Part 1
• Developing cultural change in healthcare: Part 2

To coach or not to coach?

Well, that really is a good question. Just because we are at the top of our tree, ahead of our game (or any other idiom you wish to quote), it doesn’t mean that we have everything covered. We might think that we are doing a great job but sometimes the analysis from an outside person gives us the truth that we need to improve our own skills and those of others. However, people have to be receptive to the process to achieve the best results.

Coaching Methodology is the systematic approach or set of principles that coaches use to help individuals or groups of individuals achieve their goals, improve performance and enhance their overall wellbeing. If a person’s wellbeing is high then, through a process similar to osmosis, it passes through our pores and out through our skin layers to those around us.

Different coaches may use various methodologies based on their training philosophies and the needs of the client. Below are some key elements commonly found in coaching methodologies – finding an effective method for you is paramount.

It is very important to note that coaching methodologies can vary, and coaches may integrate elements from different models and approaches based on their expertise and the unique needs of their clients. The effectiveness of coaching often depends on the quality of the coaching relationship, the coaches’ skills and the person being coached commitment to the process.

There is absolutely no point forcing a member of your team to undergo coaching, unless, of course, patient safety is at risk because of them not doing so. If someone is given an ultimatum, then they probably will not benefit from the coaching experience. However, by using the personal development route it may be better received.

Coaching methodologies to support patient safety

Now, let’s look at how these coaching methodologies and strategies can support patient safety. The infographic below provides another methodology to support patient safety.

It is an essential aspect of healthcare management and professional development. Patient safety is about preventing errors, ensuring a safe environment for patients and continuously improving healthcare practices. Let's look at the different elements of the methodology:

Continuous training and education

• Provide regular training sessions on patient safety protocols and best practices.
• Keep healthcare professionals updated on the latest advancements in safety initiatives.
• Encourage ongoing education to enhance the skills and knowledge of healthcare professionals.

Promote a culture of safety

• Foster an organisational culture that prioritises patient safety and demonstrates that it is taken seriously.
• Encourage open communication about safety concerns without fear of retribution – this links to psychological safety which is a topic that supports all elements of healthcare provision.
• Recognise and reward individuals or teams for promoting a safe environment.

Simulation and role-playing

• Conduct simulation exercises to mimic real-life scenarios and identify potential risks.
• Use role-playing to help healthcare professionals practice effective communication during critical situations.

Feedback and coaching sessions

• Provide constructive feedback on performance related to patient safety – make it a part of everyday practice within the healthcare environment.
• Conduct regular coaching sessions to discuss improvement areas and celebrate successes.
• Establish a mentorship programme to support less experienced members of the team.

Root cause analysis

• Teach and implement root cause analysis techniques to identify the underlying causes of errors and near misses. This isn’t just a senior management role, everyone should review their performance and behaviours following any patient safety incidents.
• Ensure that the information gathered is used to implement preventative measures and improvement strategies.

Team collaboration

• Emphasise the importance of teamwork and effective communications.
• Encourage interdisciplinary collaboration to address safety issues from multiple perspectives.
• Educate patients on their role in their own safety.
• Encourage patients to ask questions, communicate concerns and actively participate in their care.

It is important that regular audits and assessments take place to review processes and procedures and identify potential risks. It would be advisable to use data-driven assessments to track performance and measure improvements over time.

Encouraging a culture that is ‘just’ and recognises the difference between human error and reckless behaviour is key. It is important to have clear standards and goals for performance; that way when things are not going as they should and someone is not meeting the required benchmark, the failings can be addressed based on the task rather than it being personalised.

Skills and behaviours should be separated, and poor behaviour should not be normalised. Establish fair and consistent consequences for safety breaches while promoting a culture of learning and improvement.

By incorporating these coaching strategies, healthcare organisations can create a safer and more supportive environment for both patients and healthcare professionals.

In part two, Dawn discusses prosocial behaviours, reflective learning and how coaching can support individuals no matter where they are in their career pathway.

Further blogs from Dawn:

• Developing cultural change in healthcare: Part 1
• Developing cultural change in healthcare: Part 2

Establishing cultural change

To establish cultural change, it is important to firstly assess the culture within the service, particularly in response to incidents. It can sometimes be difficult to establish whether the current culture enables open and honest discussions at all levels among hospital teams and patients. Test this through open communication and internal audit and observation.

A cultural assessment can be an internal process whereby organisations evaluate their workplace culture. There are many tools available to support this type of evaluation; for example, Insights Discovery, My Team Radar, etc. It is statistically proven that the right behaviours within an organisation can enhance performance and wellbeing within a team. Cultural assessments generally analyse both the implicit and explicit beliefs and attitudes held by an organisation and by everyone involved. The outputs from the analysis should help leaders make informed decision about the current culture and determine if actions are necessary to strengthen the organisation and those who work within.

If a culture of openness currently exists, then to establish a programme of standardisation will be easier to achieve. However, if there is a lack of psychological safety within a team, then there will be barriers to change, and the programme of learning and education may take longer to achieve.

It will be important to consider the relationship between team members to determine if these enable them to work collaboratively, share responsibility and resolve conflict promptly and constructively – without blame.

Standardisation

When we talk about standardisation of a process, it essentially means that people working for that organisation have an established process to use. If standardisation is done well then it can decrease ambiguity about patient care and guarantee quality, boost productivity and support positive morale within a team. By standardising a process it will eliminate the need for guesswork or extra work.

Every task within any organisation, regardless of how often it is carried out, requires guidelines/rules that define the methodology that needs to be followed. If these rules are not standardised, then you can’t assess whether you are undertaking jobs effectively and ensuring a quality outcome. Standardisation also supports the reduction of human error. A standardised way of doing any task within the perioperative environment should be documented and used as a training tool for new employees.

An example of standardisation of care and change, without a mandate or guideline to follow, is the securing of a cannula. Before the most common way of securing a cannula – generally using a product similar to the 3M Tagaderm dressing – most practitioners would secure the cannula using tape and/or bandages. The driver to this change may have been around infection control issues relating to the use of tapes, which may have significantly transformed the change into an acceptable and standardised way of working.

Rules in the workplace are not only driven by policies and procedures. In many organisations, and particularly within healthcare, ‘rules’ are also established by patterns of behaviour or the ‘unwritten rules’. The ‘this is how we do it here’, type of approach can influence behaviour and expectations, often referred to as custom and practice.

In healthcare unwritten rules and ways of working can become deeply ingrained into the workplace culture and, if not managed effectively, can consequently seriously endanger patient outcomes.

Sphere of influence

As healthcare professionals you have a ‘sphere of influence’ in everything that you do. The example below shows a sphere of influence for airway management.

Essentially a clinician’s core sphere of influence is the care given to a patient allowing patients to make informed choices and support health equality. The WHO checklist is a great example of a core sphere of influence in that there is an obligation to act meaningfully to ensure the patient pathway through theatres is safe – it should not just be a ‘tick box exercise’.

Healthcare organisations have obligations to patients; however, these are not the same as those between patients and clinicians. Organisations have an obligation to provide structures that support healthcare practitioners to create a culture of integrity. By not upholding the organisation’s values they are compromising the integrity of the organisation and the long-term effectiveness.

If initiatives are implemented, they should be followed up and measured to ensure patients are getting the best possible care and employees are nurtured and reimbursed effectively for the work they undertake.

My advice would be don’t cut corners just because others say it is ok. Don’t watch others cut corners because then you are condoning poor practice and not working effectively within your sphere of influence. Ask yourself ‘what are the driving factors to cutting corners’, is it about time, saving money or something else? Work on ways to change things so patient safety is not compromised.

Change is always difficult to achieve because people become entrenched in their ways and their mindset is often ‘if it aint broke, don’t try and fix it’. However, if a product can be substituted that leads to better patient outcomes, then it should certainly be seriously considered.

NHS England says that:

"Patient Safety is the avoidance of unintended or unexpected harm to people during the provision of healthcare. We support providers to minimise patient safety incidents and drive improvements in safety and quality. Patients should be treated in a safe environment and protected from avoidable harm."

If you can drive forward on a patient safety initiative that supports better patient outcomes, then do so. Who knows, you may become a patient safety champion who advocates for better patient results. Also, remember, you or a member of your family may one day be a patient and you wouldn’t want somebody to be cutting corners or compromising your safety because it’s quicker and easier to do so.

There have been many incidents in healthcare that have led to employees feeling less than empowered and frightened to speak up and speak out. Ongoing scandals and behaviours will forever challenge all of those who work within the healthcare environment, particularly if cultural issues are not addressed.

Working towards cultural change in healthcare will take time and persistence. It involves not only implementing new policies and procedures but also changing mindsets and behaviours. Consistent effort, leadership support and a commitment to patient safety will be key to your success, no matter who you are or at what level you work.

It will take a sensitive and pragmatic, evidence-based approach to challenge culture and practice within any speciality.

Corporate culture and corporate memory are manifested in how decisions are made and the results of those decisions; i.e., the actions taken to support better outcomes. It is also about how we engage with individuals to encourage them to give of their best, support best practice and not be maligned for speaking up if things are not as they should be.

Across the healthcare sector, organisations will endeavour to provide a safe and sustainable service that improves outcomes for patients and their families. To develop a programme of change the following steps may support you to achieve good solutions:

Leadership commitment

• Engage leaders: gain commitment from top-level executives, administrators and department heads. Leaders must champion the cultural change and lead by example. The enormity of this may seem daunting; however, it is achievable if you have a structured plan and a strong vision. It takes one person to stand out in the crowd to ensure they have followers. There is a great video on YouTube that shows how important followers are to anyone in a leadership position.

Assessment and awareness

• Assess current culture: carry out a thorough assessment of the current organisational culture. Identify areas that need improvement, especially related to patient safety (see point below about cultural assessment).
• Awareness building: raise awareness about the importance of patient safety and its impact on overall healthcare quality among all staff members and the patients they support.

Define cultural values

• Establish core values: define and communicate core values relating to patient safety, such as transparency, open communication, accountability and a commitment to continuous improvement.

Communication and training

• Training programmes: develop comprehensive training programmes for health teams at all levels. This should include training on patient safety, communication skills, teamwork and conflict resolution.
• Effective communication: Promote open and effective communication among healthcare teams. Encourage staff to voice concerns and report errors without fear of reprisal. This isn’t about putting your colleagues into the spotlight if they are underperforming, it is about improving standards and reducing blame.

Patient-centred care

• Patient involvement: involve patients in their decisions, making them active partners in the healthcare process.
• Empathy and compassion: emphasise empathy and compassion in patient interactions. Practitioners should understand and respect the unique needs and preferences of each patient.

Data and metrics

• Collect data: implement data collection systems to track patient safety metrics and outcomes.
• Feedback loops: establish feedback loops that allows colleagues to review and learn from incidents and near misses.

Accountability and reporting

• Accountability measures: define clear lines of accountability for patient safety at all levels of the organisation.
• Reporting systems: create systems for reporting adverse events, near-misses and safety concerns. Encourage a culture of reporting rather than blame. Encouragement can come through using corporate governance structures to ensure greater transparency and accountability.

Continuous improvement

• Quality improvement teams: form multidisciplinary quality improvement teams to identify areas for improvement and to implement evidence-based practice. These may already be in place in many organisations; however, sadly they may not or may not be fully utilised.
• Regular audits: conduct regular audits and reviews to ensure compliance with patient safety protocols.

Recognition and rewards

• Recognise achievements: acknowledge and celebrate successes and improvements related to patient safety. Raise awareness of your organisation and put yourselves up for national awards such as the annual HSJ awards. We often work in an environment and don’t realise we are doing great things that should be celebrated.

Sustainability

• Embed into the organisations culture: patient safety and a culture of continuous improvement should become ingrained in the organisational ethos and not just be a temporary initiative. Sustainability is key on achieving success.

External benchmarking

• Benchmark against industry standards: compare your organisation’s patient safety practices with industry benchmarks and best practices. Seek external guidance and certification if possible. (The Association for Perioperative Practice offer an Audit and Accreditation Programme to support the NHS and private sector.)

Feedback and adaptation

• Regular feedback: continuously seek feedback from patients, families and staff to adapt and refine your patient safety initiatives.

In part two, Dawn will give you tips on how to assess the culture of your organisation and establish a programme of standardisation.

The seven principles below provide guidance for creating an employee recognition strategy that connects your people to your organisation’s purpose and to one another.

1. Align your recognition strategy to your organisation’s purpose and values

Tell the story of how you connect the recognition of your staff to your organisational purpose to deliver excellent care for patients/service users. Show specifically how your people’s dedication and contribution at work makes a difference to your organisation, patients/service users and the wider health and care system.

2. Recognise people for a multitude of accomplishments

Recognise people for their personal career achievements, team successes, effort and work milestones. Everyone, from the new nurse who has recently completed their preceptorship through to the nurse that has just hit a forty-year milestone, must be appreciated to enable them to feel valued.

3. Incorporate both manager and peer-to-peer recognition

Recognition can be meaningful for people when it comes from both their manager and their peers. Enable leaders and managers to create their own recognition approaches that are aligned to their own team’s objectives. Encourage people to recognise one another following their own positive experiences and interactions as part of strengthening working relationships and creating a culture of recognition.

4. Give everyone a chance to recognise and be recognised

Provide different tools to enable people to recognise one another. Different working arrangements should also be considered. For instance, an intranet system might work well for home-based staff, but not all employees will have access to the internet or the opportunity to check their phone during work hours.

5. Ensure any awards are appropriate

There is no one-size-fits-all award type. When designing formal awards, ensure that the specific award and experience are sensitive to the broader context. For example, consider for an awards ceremony, consider how this might be perceived by your staff and the wider public and the best use of staff time and taxpayer funds.

6. Involve your staff at every stage

What works in one organisation might not work in another. So, involve your staff in the concept, design, delivery and evaluation of any recognition strategy. This allows your strategy to be staff-led and sensitive to local need.

7. Evaluate and refresh your approach regularly

What worked last year might not work this year. Review your strategy regularly (at least annually) to ensure it is adaptive to changes in the need of staff and the broader context. Re-evaluate any tools or interventions to ensure people are still utilising them and finding them valuable.

I was at the NHS Confed Expo last week. After lunch I was whizzing over to the innovation area to, ironically, listen to an AHSN presentation on patient safety, when I decided to cut across the NHS Confederation stand. I tripped up the step and body surfed along the blue carpet grazing elbows and knees, ipad, pen and notebook flying.

Apart from being mortified, I got up and the people around me asked if I was ok. Apart from my pride and some minor wounds I was fine and continued to my session.

However, when I got home later that evening and recounted the story to my family over dinner, the first thing my husband said was "Did you report it." I replied "No?". He then followed up with "Did anyone else report it?" Again, "No, I don’t think so".

“Well, there’s your problem right there with safety in the NHS – a safety culture that’s so poor that a harm and potential hazard was not reported. Was there a handrail? A sign 'watch the step’, any yellow hazard tape?" "No", I replied.

 “So in a conference centre of NHS Managers nobody who saw you fall knew this was a reportable incident?" That was me told.

This may sound like an odd conversation for Wednesday night dinner, but my husband has worked in the chemical industry for over 30 years where safety culture means something totally different – they really do live and breathe it. That old adage 'the standard you accept is the standard you walk past’ is still something we don’t get in the NHS.

 He went on to describe how 30 years ago, ICI would have 'Hold the handrail' signs on all stairwells. People thought this was over the top, but still 30% of harms in the chemical industry come from slips, trips and falls (and you can be more assured that this figure is accurate as they do actually report them). One of the biggest safety issues is people falling off kerbs while catching up on their socials. We still have a long way to go...

I have reflected on this conversation and my poor behaviour in terms of not reporting this and hope that in future I will respond differently and I hope others will too. So for those who watched the middle-aged lady in a red and white dress take a tumble last Wednesday afternoon, this poem is for you:

Willmott Dixon Health and Safety Poem - YouTube. Poem by Don Merrell.

The findings are captured in this report, which provides insights from 13 examples of interventions. The report details the learnings from these interventions, including important facilitators and barriers that affected the success of each intervention. Examples of some of the interventions the report details include overhauling staff rotas and shift patterns, removing bureaucracy and meeting times, changing patient care processes, co-designing fatigue management strategies, and improving team formation and psychological support.