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Found 199 results
  1. Content Article
    It's that time again. 'Speak Up Month' in the NHS. In this blog, I discuss the definition of 'whistelblowing' and why this is important. I believe that although the Francis Report has stimulated some positive changes, the only way to successfully move forward on this is to celebrate and promote genuine whistleblowers. This includes using the word 'whistleblowing', not a euphemism. It also needs us to involve everyone, including patients, in the changes. "Whistleblowing isn’t a problem to be solved or managed, it’s an opportunity to learn and improve. The more we move away for labelling and stereotyping the more we will learn. Regardless of our position, role or perceived status, we all need to address this much more openly and explicitly, in a spirit of truth and reconciliation." What is whistleblowing? "In the UK, NHS bodies have been guilty of muddying the waters. Sometimes implying that whistleblowers are people who fail to use the proper channels, or are troublemakers, especially when they go outside their organisation with their concerns. In fact, the Public Interest Disclosure Act makes no distinction between ‘internal’ and ‘external’ whistle-blowers..."
  2. News Article
    NHS whistleblowers have required counselling and medication and a quarter would not raise concerns again due to the stress and lack of support, a report found. A review of existing policy at NHS Greater Glasgow and Clyde found “concerning” evidence of a significant impact on the mental health of both whistleblowers and managers with little support provided. It found there was “no clear documented process” to highlight serious, urgent issues to the appropriate manager. Healthworkers’ union Unison said staff were often labelled ‘trouble-makers’ with senior managers "defensive from the outset". Sixty percent of staff reported that their mental health was negatively impacted by whistleblowing with some requiring counselling or medication to cope with the stress of disclosures. The report said it was of concern that a quarter of staff stated that they would not raise concerns such as unsafe clinical practices again given their experiences, a figure which it said was likely to be higher as this information was only recorded if it was volunteered by staff. Unison’s Regional Organiser Matt McLaughlin said, “Unison welcomes this paper and the Boards commitment to follow the updates national guidance. “However it will take more than a new policy for whistleblowers to feel valued within NHS GGC. The organisation is too defensive and staff who whistleblow often do so out of shear frustration that legitimate concerns are ignored – or worse, where the whistleblower is seen as a trouble maker. " "NHS Greater Glasgow and Clyde needs to embrace and welcome staff speaking out; rather than being defensive from the outset." Read full story Source: The Herald, 28 April 2021
  3. Content Article
    In this blog the Safer Healthcare and Biosafety Network and Patient Safety Learning reflect on the results of the NHS Staff Survey 2020, considering how staff safety relates to patient safety in the context of this.
  4. Content Article
    This poster was presented by Hugh Wilkins at the UK Imaging and Oncology Congress in June 2019 and highlights the serious problem of retaliation against NHS staff who raise concerns in the public interest.
  5. Content Article
    In this story from a former Policy & Performance Officer, the truth is told about how ineffective hierarchies often result in a culture of dishonesty.
  6. News Article
    Hospitals and care homes are failing to properly investigate incidents before referring nurses to their regulator, fuelling a blame culture and repeat failures, the head of the nursing watchdog has told The Independent. In her first national interview, Andrea Sutcliffe, head of the Nursing and Midwifery Council (NMC) said some employers were referring nurses without any investigation at all, while half of initial enquiries to the NMC were rejected or required further work. She told The Independent this emphasis on blaming the individual meant underlying causes of safety errors were being missed and so they were likely to be repeated. Her ambition is to transform the nursing regulator, which oversees 725,000 nurses and midwives across the UK, into a more forceful watchdog that will flag systemic issues of concern with NHS trusts and care homes. In a wide-ranging interview, Ms Sutcliffe called on ministers to ensure that planned legislation to reform the way clinicians are regulated be made transparent and maintain the public’s confidence. She also stressed that the impact of coronavirus on nurses mental health meant rushing to restart routine operations in the NHS had to be carefully planned to avoid driving nurses out of the health service. Read full story Source: The Independent, 16 March 2021
  7. News Article
    People living with HIV in England and Wales can now choose to have their Covid vaccine through specialist clinics, without notifying their GP. NHS England has updated its guidance for people not comfortable with sharing their status. Everyone with HIV should be in vaccine priority groups four or six, and offered a jab by mid-April at the latest. But campaigners worried stigma would cause some to miss out. The updated guidance, obtained by the i newspaper, follows the lead of NHS Wales which put the same measures in place last week. Head of leading HIV charity the Terrence Higgins Trust, Ian Green, said: "Some may be surprised to hear that a significant number of people living with HIV feel unable to talk to their GP about their HIV status, but this underlines how much stigma still surrounds the virus even in 2021." "This is great news and the right decision from the NHS as it means people living with HIV will be able to take up the potentially life-saving Covid-19 vaccine at their earliest opportunity. We are working towards a society where everyone living with HIV feels comfortable sharing their status with their doctor and other health professionals, but we're not there yet and we welcome this fast, pragmatic action." Read full story Source: BBC News, 22 February 2021
  8. Content Article
    Jeremy Hunt asks the Secretary of State for Health and Social Care, Helen Whately, what proportion of NHS staff have experienced bullying and harassment in the workplace in each year from 2010 to 2020.
  9. News Article
    Bosses at the controversial NHS gender-change clinic for children have been removed after regulators highlighted a string of failures. The management team of the Gender Identity Development Service (GIDS) in London has been 'disbanded', documents reveal. It comes weeks after the clinic, run by the Tavistock and Portman NHS Trust, was judged 'inadequate' by the Care Quality Commission. Watchdogs said staff were afraid to raise concerns about patient safety for fear of 'retribution' from bosses. A report said: 'Staff did not always manage risk well. Many of the young [patients] were vulnerable and at risk of self-harm." The management team of the Gender Identity Development Service (GIDS) in London has been 'disbanded', documents reveal. It comes weeks after the clinic, run by the Tavistock and Portman NHS Trust, was judged 'inadequate' by the Care Quality Commission. "The size of the waiting list meant staff were unable to proactively manage the risks to patients waiting for a first appointment." Read full story Source: MailOnline, 31 January 2021
  10. Content Article
    So far in our 2020 overview series, we’ve heard an introduction to how the year has gone from our Chief Executive Helen Hughes, and looked at the impact of the COVID-19 pandemic on patient safety, as well as the work we’ve done in the areas of Long COVID and painful hysteroscopies. In our penultimate blog of the series, we turn our attention to the work we’ve done in staff safety.
  11. News Article
    Women in a newly opened psychiatric intensive care unit (PICU) had concerns for their sexual safety, a Care Quality Commission (CQC) report has revealed. Inspectors found women in the PICU at Cygnet Health Care’s Godden Green Hospital, in Kent, were afraid to shower because male staff did not always knock before entering bedrooms and staff entered bathrooms without permission. Patients were often looked after by male staff despite having asked for a female staff member and, in some cases, had an all-male care team. Most patients the inspectors spoke to had concerns about their sexual safety. The CQC carried out an unannounced inspection of the PICU in October, following concerns raised by members of the public and to check concerns identified in an earlier inspection of the hospital’s child and adolescent mental health services were not organisational. The PICU opened in November 2019. Since the summer, Kent and Medway NHS and Social Care Partnership Trust has commissioned some of the beds, but HSJ understands it stopped admissions for a time to review the care being provided. Inspectors found records referred to PICU patients as “difficult” and “troublemakers” and warned a ”culture of negativity towards patients had developed among some staff”. Read full story (paywalled) Source: HSJ, 4 December 2020
  12. News Article
    The Care Quality Commission (CQC) has raised serious concerns about a major teaching trust’s maternity services and taken action to prevent patients coming to harm. The watchdog has imposed conditions on the registration of Nottingham University Hospitals Trust’s maternity and midwifery services at Nottingham City Hospital and Queen’s Medical Centre and rated them “inadequate”. Following an inspection in October, the CQC identified several serious concerns, including leaders lacking the skills to effectively head up the service, a lack of an open culture where staff could raise concerns, and staff failing to complete patient risk assessments or identify women at risk of deterioration. In its findings, the CQC reported how “fragile” staff wanted to escalate their concerns directly to the regulator, particularly around the leadership’s response to the “verbal outcome of the inspection”. The regulator called this “further evidence of the deep-rooted cultural problems” and escalated these concerns directly to trust CEO Tracy Taylor, who would be “personally overseeing the improvement process required”. Inspectors also found the service did not have enough staff with the right skills, qualifications and experience to “keep women safe from avoidable harm”. The CQC also issued the trust a warning notice over concerns around documenting risk assessments and IT systems. The trust has three months to make improvements. Read full story (paywalled) Source: HSJ, 2 December 2020
  13. Content Article
    Those who have read Professor Edmondson's book "The Fearless Organization" will know that psychological safety is required for team high-performance. Psychological safety is defined as "a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes". If you do not feel safe in a group, you are likely to keep ideas to yourself and avoid speaking up, even about risks. Furthermore, if mistakes are held against you, you then look to avoid making mistakes and so stop taking risks, rather than making the most out of your talents. Low psychological safety, therefore, gets in the way of both team performance, innovation, learning, and personal success. For you to be successful in your team, and "as a team", psychological safety is the enabler. In collaboration with professor Amy C. Edmondson, The Fearless Organization has developed 'The Fearless Organization Scan'. This scan maps how team members perceive the level of psychological safety in their closest context. To improve team performance, it helps to know the Psychological Safety levels in your team, as this is a critical predictor of how your team will learn and work together. By improving the level of psychological safety, you significantly increase the likelihood of team success.
  14. News Article
    Organisations across the UK and beyond are set to benefit from a unique NHS- academic partnership which sees a focus on staff safety and morale – and delivers significant cost savings. Together Northumbria University and Mersey Care NHS Foundation Trust are pioneering professional development courses on Restorative Just Culture. This approach at the Liverpool-based Trust has seen reduced dismissals and suspensions, leading to substantial business savings, and has generated great interest across the health sector. Starting in 2016 Mersey Care has worked to deliver a Restorative Just Culture. And despite increasing its workforce by 135%, the Trust has since seen an 85% reduction in disciplinary investigations and a 95% reduction in suspensions – helping them drive down costs significantly. During the same period, it has also seen improved staff engagement and safety culture scores as measured by the NHS national staff survey. Mersey Care’s Executive Director of Workforce Amanda Oates says: “Mersey Care started on our journey towards a Restorative Just and Learning Culture after conversations with our staff about the barriers staff faced delivering the best care that they could possibly give." “The feedback was overwhelmingly about the fear of blame if something didn't go as expected. This was preventing staff from telling us what wasn’t working. More importantly, it was preventing the opportunity for learning from those things to prevent them from happening again. As a Board, we had the conversation - are we looking at problems the wrong way?” Read full story Source: FE News, 27 October 2020
  15. Content Article
    In her guest blog for the Professionals Standard Body (PSB), Sarah Seddon talks about the Duty of Candour and how it's affected her personal life.
  16. Content Article
    This year's World Patient Safety Day focuses on both patient and staff safety. Human Factors science keeps patients safe, but also helps keep staff safe, physically and psychologically.  Martin Bromiley has written a a special one page opinion piece for the Clinical Human Factors Group about the behaviours that help create psychological safety.
  17. News Article
    A hospital boss championed by Matt Hancock has been told to end “a toxic management culture” after doctors were asked to provide fingerprint samples to identify a whistleblower. The Royal College of Anaesthetists (RCoA) has urged the chief executive of West Suffolk hospital, Steve Dunn, who Hancock described as an “outstanding leader”, to take urgent action to improve the wellbeing of senior clinicians and “thereby the safety of patients”. In a strongly worded letter sent to Dunn in July, seen by the Guardian, the RCoA president, Prof Ravi Mahajan, reminded him that “undermining and bullying behaviour is unacceptable”. Following a three-day review of the hospital, Prof Mahajan’s letter said senior anaesthetists had complained about a “toxic management culture that risks impairing their ability to care safely for patients”. The incident, and other failings in patient safety, contributed to the hospital becoming the first ever to be relegated by Care Quality Commission (CQC) inspectors from “outstanding” to “requires improvement” in January. A spokesman for the trust said: “Ensuring our colleagues work in a supportive, safe environment is good for our staff and means better patient care, which is why we have done extensive work this year to act on feedback about our working culture, including taking action to address the concerns raised by the Royal College of Anaesthetists.” Read full story Source: The Guardian, 11 September 2020
  18. Content Article
    As highlighted by NHS England with the NHS People Plan[, healthcare organisations that prioritise workforce wellbeing will be better placed to put lessons learnt from the coronavirus pandemic into practice. Phil Taylor of RLDatix outlines the benefits of introducing a just culture not a blame culture and shares a methodology for positive change.
  19. Content Article
    The cost of providing care during a pandemic is seeing firsthand the evolution of medical knowledge, and wishing current data could have guided past decisions, says Eric Kutscher in this BMJ Opinion article.
  20. Content Article
    Most healthcare professionals are familiar with Datix incident reporting software. But how and why has Datix become associated with fear and blame? Datix’s former chief executive and now chairman of Patient Safety Learning, Jonathan Hazan, looks at why this has come about and what needs to be done to improve incident reporting.
  21. Community Post
    Most healthcare professionals are familiar with Datix incident reporting software. But how and why has Datix become associated with fear and blame? Datix’s former chief executive and now chairman of Patient Safety Learning, Jonathan Hazan, has written a blog for the hub looking at why this has come about and what needs to be done to improve incident reporting. Do you have any ideas on how we can improve incident reporting? We'd love to hear from you. Reply to this topic below.
  22. Content Article
    On Thursday 30 July 2020, NHS England and NHS Improvement published the NHS People Plan for 2020/21. Building on the Interim NHS People Plan released in 2019, it describes itself as focusing on “how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as action to grow our workforce, train our people, and work together differently to deliver patient care”. In this blog, Patient Safety Learning looks at the People Plan with specific reference to its approach to tackling the blame culture in the NHS, which is a significant factor in the safety of patients and staff. It highlights where we think the People Plan has not addressed these well-known concerns and what more needs to be done urgently.
  23. Content Article
    Findings from the APPG for Whisltblowing's report show that whistleblowing cases continue to have a low success rate, with whistleblowers suffering more and for longer than before, writes Mary Robinson.  Whilst there are laws in place to protect whistleblowers, the overwhelming evidence is that they have failed to address the principal issues they face. Politicians have a duty to confront the most difficult things, including the barriers to justice and the fear of retaliation that make it impossible or futile for people across all sectors to speak up safely. Mary, the Conservative MP for Cheadle and chair of the APPG for whistleblowing, says that a system that works with whistleblowers instead of against them, would serve to protect employees and would empower them to do the right thing. Although the UK was the first in Europe to introduce legislation with Public Interest Disclosure Act 1998, we are in danger of falling behind global best practice. In this blog, Mary proposes and urgent reform of existing legislation and the introduction of an Office of the Whistleblower is needed to reset the gold standard.
  24. Content Article
    At its heart, Appreciative Inquiry (AI) is about the search for the best in people, their organisations, and the strengths-filled world around them. It is the art and practice of asking questions that strengthen a system’s capacity to heighten positive potential, (Stavros et. al (2015) Appreciative Inquiry: Organisation Development and the Strengths Revolution). In this area you will find useful resources relating to the aspect covered below. 
  25. Content Article
    In healthcare systems safety needs to be conceived in a relational as well as a regulatory framework, with resilience being understood as the interplay between both elements. This presentation from the Australian Institute of Health Innovation, critically appraises how harm is understood and responded to within the New Zealand health system and the potential contribution of restorative responses. A major and internationally unprecedented project, that employed a restorative approach to address the harm caused to patients and professionals by the use of surgical mesh in New Zealand (NZ), is used to illustrate the case for change.
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