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Showing results for tags 'Organisational culture'.
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Content ArticleOn 24 August 2022, the Employment Tribunal found that Mr Shyam Kumar, a consultant orthopaedic surgeon employed at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMB), had been disengaged from his role as a Specialist Advisor within the Care Quality Commission (CQC) on account of having made “protected disclosures” to the CQC. This means he had raised concerns with CQC about the health of patients and other important issues and had done so in the public interest. The Employment Tribunal found that the fact that he had raised these various concerns with CQC had materially influenced its decision to disengage him. It awarded him £23,000 in damages for injury to feelings, on account of what it described as “the inevitable impact” of CQC’s actions upon Mr Kumar’s reputation among his peers and the shock, confusion and concern it caused to him. The CQC has accepted these findings and apologised to Mr Kumar. CQC’s Chief Executive, Ian Trenholm, issued a public statement on 6 September 2022 about what occurred, including a recognition of the importance of the concerns Mr Kumar raised, the importance of the information raised by staff and the public generally, and the “vital role” played by Specialist Advisors in CQC’s inspections. Following this, Zoe Leventhal KC was appointed by CQC’s Executive Board to carry out an independent review into whether CQC took appropriate action as a regulator in response to the protected disclosures that Mr Kumar made, and whether it dealt appropriately with a sample of other instances where concerns have been raised with CQC.
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Content ArticleThe concerns that health and care workers and the public share with the Care Quality Commission (CQC) about health and care services are critical to its work. It is also vital that CQC listens to its own staff. This review explores whether there are areas of culture or process within CQC that need to be improved in relation to listening, learning, and responding to concerns. The review focused on these key areas: Organisational findings Reviewing how well we listen to whistleblowing concerns. Reviewing our Freedom to Speak Up policy. Learning from the tribunal case. Reviewing how we listen to our staff. Reviewing the expectations and experiences of people who raise concerns with us.
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Content Article
Leadership in the NHS (BMJ Leader, 20 December 2019)
Patient-Safety-Learning posted an article in Leadership
In healthcare, leadership has a big influence on quality of care and the performance of hospitals. How staff are treated significantly influences care provision and organisational performance, so understanding how leaders can help ensure staff are cared for, valued, supported and respected is important. Research suggests ‘inclusion’ is a critical part of the answer. In this article, Roger Kline looks at how creating a compassionate, inclusive culture improves patient safety—and by contrast, how a culture of fear and bullying has a negative effect. He examines why toxic leadership cultures develop and what can be done to transform leadership in NHS organisations. -
Content ArticleA number of serious concerns have been raised about the University Hospitals Birmingham NHS Foundation Trust, relating to patient safety, governance processes and organisational culture. The Trust has been under review by the Birmingham and Solihull Integrated Care Board (ICB), following a junior doctor at the trust, Dr Vaishnavi Kumar, taking her own life in June 2022. In response to these concerns, a series of rapid independently-led reviews have been commissioned at the Trust. This report outlines the outcomes of the first of these reviews, which is focused on clinical safety. It identified a number of issues which require attention, setting out 17 recommendations for further action.
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In this blog, Patient Safety Learning looks in detail at the results of the NHS Staff Survey 2022, focusing on responses relating to reporting, speaking up and acting on safety concerns. It includes the following key points: It is difficult to imagine other safety critical industries would deem these results acceptable. Nearly half of all respondents did not feel confident their organisation would address their concerns about unsafe clinical practice. It is hugely concerning that over 40% of respondents could not say that they would be treated fairly if involved in a patient safety incident. This could significantly undermine the willingness of staff to raise concerns, with significant consequences for patient safety. There needs to be greater urgency to improve the safety culture in the health service. NHS England needs to recognise the scale of this challenge and provide clarity on how it will work with organisations to tackle this. NHS England, working in partnership with the National Guardian and the Care Quality Commission, should bring forward as a matter of urgency robust and specific commitments to drive forward the work of improving the safety culture in the NHS. -
Content ArticleGPs in the UK are under extreme strain and public satisfaction with general practice has plummeted. Pressures on general practice are not unique to the UK and GPs around the world are contending with the impact of the pandemic on their patients and working lives. The 2022 Commonwealth Fund survey compares perspectives from GPs across 10 high‑income countries. The survey asked GPs’ views about their working lives and wellbeing, quality of care and how services are delivered. The Health Foundation analysed the survey data to understand the experiences of GPs in the UK and how they compare to other countries.
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Content ArticleNiche Health and Social Care Consulting (Niche) were commissioned by NHS England in November 2019 to undertake an independent investigation into the governance at West Lane Hospital (WLH), Middlesbrough between 2017 up to the hospital closure in 2019. WLH was provided by Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) and delivered Tier 4 child and adolescent mental health services (CAMHS) inpatient services. This review initially incorporated the care and treatment review findings of two index case events for Christie and Nadia who both died following catastrophic self-ligature at the unit. The Trust subsequently agreed to include the findings of the care and treatment review of Emily which related directly to her time at West Lane Hospital, even though Emily did not die at this site. This is to ensure that optimal learning could be achieved from this review.
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Content ArticleEvery day, healthcare professionals face the risk of traumatic events — such as an unexpected death, a medical error, or an unplanned transfer to the ICU. Yet few hospitals have programmes to support “second victims.” Too often, these employees experience self-doubt, burnout and other problems that cause personal anguish and hinder their ability to deliver safe, compassionate care. The Caring for the Caregiver programme from John Hopkins Medicine in the USA guides hospitals to set up peer-responder programmes that deliver “psychological first aid and emotional support” to health care professionals following difficult events. Modelled on the Resilience in Stressful Events (RISE) team at The Johns Hopkins Hospital, the programme prepares employees to provide skilled, nonjudgmental and confidential support to individuals and groups.
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Content ArticleThe aim of this article is to enable nurses to understand the powerful role of organisational culture in influencing the effectiveness of healthcare delivery, primarily within the NHS.
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Content ArticleNuffield Trust’s fifteenth annual Summit took place in March 2023. These videos feature highlights of the speaker sessions: Diagnosing the NHS Priorities in social care Community and rehabilitation services - the key to easing gridlock? Addressing inequalities in general practice - politics, policy and reality Solving the workforce burnout crisis Improving communication between the NHS and the public Changing the centralised culture of the NHS
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In a series of blogs for the hub, we will be highlighting the impact fatigue has on staff and patients. In their first blog, Emma Plunkett and Nancy Redfern, part of the Joint Working Group on Fatigue, shared how they became involved in investigating night shift fatigue, setting up the Joint Working Group on Fatigue and the aims of the #FightFatigue campaign. In this second blog, Emma and Nancy are joined by Roopa McCrossan to highlight how tiredness can impact on our performance, the patient and staff implications of fatigue, and the actions that need to be taken not only at an organisational level to improve culture, but the effort required at national level too.- Posted
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Content ArticleIn this article, the Association of Anaesthetists (AoA) outlines its three-point plan to address the culture surrounding healthcare professional fatigue in hospitals and tackle the problem of excessive fatigue. Part of the AoA's #FightFatigue campaign, the plan involves the following aspects: Detection Education Prevention
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Patient Safety Learning recently interviewed Keith Conradi, former HSIB chief executive, on why healthcare needs to operate as a safety management system. In this interview, we speak to Jono Broad, part of the South West Integrated Personalised Care team at NHS England, to hear his response to this, how patients, families and relatives can get involved, and why we need to really embed patient safety in a management culture and a healthcare management system.- Posted
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Content Article
NHS Staff Survey Results 2022 (9 March 2023)
Patient Safety Learning posted an article in Culture
The NHS Staff Survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. 636,384 staff responded to the survey in 2022. The full results of the 2022 NHS Staff Survey are published on the NHS Staff Survey website. -
Content ArticleMedical errors, especially those resulting in patient harm, have a negative psychological impact on patients and healthcare workers. Healing may be promoted if both parties are able to work together and explore the effect and outcome of the event from each of their perspectives. There is little existing research in this area, even though this has the potential to improve patient safety and wellness for both healthcare workers and patients. Using a patient-oriented research approach, this study in BMJ Open Quality examined the potential for patients and healthcare workers to heal together after harm from a medical error. The study's findings suggest that, after a medical error causing harm, both patients and healthcare workers have feelings of empathy and respect towards each other that often goes unrecognised. Barriers to communication for patients were related to their perception that healthcare workers did not care about them, showed no remorse or did not admit to the error. For healthcare workers, communication barriers were related to feelings of blame or shame, and fear of professional and legal consequences. Patients reported needing open and transparent communications to help them heal, and healthcare workers required leadership and peer support, including training and space to talk about the event.
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Content ArticleIs the NHS really full of ‘overpaid pen-pushers’? In this podcast, host Jo Vigor talks to guests about the critical role of NHS managers and what it means to bring your humanity to work. Guests: Dr Seema Srivastava, Deputy Medical Director at University Hospitals Bristol and Weston NHS Foundation Trust Emma Challans-Rasool, Founder and Chair of the Proud2bOps operational network and Director of Organisational Development, Culture and Talent at Nottingham and Nottinghamshire Integrated Care System Rachel Burnham, Director of Performance and Information at Guy's and St Thomas's NHS Foundation Trust
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Content ArticleIn this blog, Dr Ciaran Crowe, an ST6 doctor in obstetrics and gynaecology, talks about bullying in the healthcare system and what we can do to tackle unacceptable behaviour. He highlights the results of the 2014 National Training Survey, in which 8% respondents reported being bullied and 13.8% reported witnessing bullying, and points out that certain specialities have a higher than average number of bullying incidents reported. He also examines the triggers for bullying in healthcare settings and looks at ways to tackle the issue.
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Content ArticleIt's now a decade since the Francis Report, which outlined the causes of serious failures in care at Mid Staffordshire NHS Foundation Trust. The report and prior media coverage exposed a wide set of issues surrounding the culture and transparency of health care, and these topics remain of major concern today. In this article for the Nuffield Trust, Shaun Lintern has interviewed Sir Robert Francis KC about the weight of those patient stories and treatment of the NHS's staff, then and now.
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Content Article
In a series of blogs for the hub, Emma Plunkett and Nancy Redfern, part of the Joint Working Group on Fatigue, will highlight the impact staff fatigue has not only on the staff themselves but also on patient safety, and why healthcare needs a robust fatigue risk management system like other safety-critical industries. In their first blog, Emma and Nancy share how they became involved in investigating night shift fatigue after the death of a colleague driving home tired. They discuss how they set up the Joint Working Group on Fatigue and the aims of the #FightFatigue campaign. -
Content ArticleVictoria Vallance, Director of Secondary and Specialist Care, provides an update on the Care Quality Commission (CQC)’s ongoing national maternity inspection programme and offers early insight into the emerging themes, including good practice examples to support wider learning across all trusts.
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Content ArticleThis study from Jones et al. identified wide variability in the implementation of the Guardian role and concluded that optimal implementation has six components.
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Content ArticleThis systematic review in the Western Journal of Nursing Research examined the relationship between hospital nurse fatigue and outcomes. The authors found that fatigue was consistently associated with mental health problems, decreased nursing performance and sickness absence. Many studies confirmed that nurse fatigue is negatively associated with nurse, patient-safety and organisational outcomes. The review also highlighted gaps in current knowledge and the need for future research using a longitudinal design and measuring additional outcomes to better understand the consequences of nurse fatigue.
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Content ArticleIn light of NHS England recently losing an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, Roger Kline casts light on learnings from the case for NHS board members and HR departments.
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Content ArticleThe National Guardian’s Office has published Listening to Workers – the report following its Speak Up review of NHS ambulance trusts in England. The review found the culture in ambulance trusts did not support workers to speak up and that this was having an impact on worker wellbeing and ultimately patient safety.
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Content ArticleIn this opinion piece for US website Stat, Michael Millenson explores how financial factors have contributed to the lack of progress in reducing avoidable harm in the US over the past decade. He argues that the private, insurance-based system means that hospitals make more money from patients with complications, therefore patient safety improvements reduce healthcare organisations' profits. He highlights that research demonstrating this link is only now uncovering what hospital executives have known for years—that current payment structures may “reduce the willingness of hospitals to invest in patient safety.”
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