Independent Organisational Culture Review: Report for University Hospitals Birmingham NHS Foundation Trust (27 September 2023)

Summary

The Culture Review report was published following an independent external review of the organisational culture at University Hospitals Birmingham Trust. The external review was carried out by consultancy firm The Value Circle following a series of investigations into problems at University Hospitals Birmingham Foundation Trust over the last year.

Content

The review found that, despite significant challenges in staff experience at the Trust, many staff remain committed and proud to provide care to the population they serve. Staff experience at the Trust needs dedicated and continued focus to make positive shifts to a working environment where all staff feel safe, heard, and valued.

The review team found a challenging staff experience that has manifested itself over a long period of time, has largely continued unchecked, and has created a culture where for many, an adverse working environment has become normalised. There is currently not a single defining culture at the Trust, but there are commonalities of experience. The culture is comprised of many individual views and interpretations which means staff experience the Trust in different ways. For many of the staff who engaged with the review, their experience of working in the Trust is compromised, with a range of concerns. These include not feeling valued and respected, often not feeling safe at work, and not connected to the wider organisation in which they serve. Staff also reported not feeling included and not having a voice that is heard and acted upon. For some staff this has impacted on their wellbeing.

Going forward, the Board must acknowledge the culture at UHB needs to significantly improve. The Board, supported by senior management and staff, must create the conditions for change. This should include zero tolerance for poor behaviour so staff feel they can contribute, collaborate, have their voice heard, and feel their work is valued. Staff should be empowered to lift their heads up and enabled to do the right thing. Empowerment should not be simply handing off responsibility to staff, but listening and engaging in co-production, development, and improvement.

The four fundamental shifts the review recommend are:

• A shift to openness and transparency.
• A shift to valuing people and ensuring equity and inclusion .
• A shift to ensuring culture directly connects to effective patient care.
• A shift to ensuring a physically and psychologically safe working environment.