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Showing results for tags 'Organisational culture'.
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"I am thirty miles south of London’s Gatwick Airport, the world’s busiest single-runway airport, when one of the seven Flight Control computers in my Airbus A320 aircraft fails . . . ’ So begins this pioneering book by Niall Downey – a cardio-thoracic surgeon who retrained to become a commercial airline pilot – where he uses his expertise in medicine and aviation to explore the critical issue of managing human error. With further examples from business, politics, sport, technology, education and other fields, Downey makes a powerful case that by following some clear guidelines any organisation can greatly reduce the incidence and impact of making serious mistakes. While acknowledging that in our fast-paced world getting things wrong is impossible to avoid completely, Downey offers a strategy based on current best practice that can make a massive difference. He concludes with an aviation-style Safety Management System that can be hugely helpful in preventing avoidable catastrophes from occurring. -
Content ArticleThe state of medical education and practice in the UK 2023 is published at a time when the UK health systems face extensive challenges. This report from the General Medical Council (GMC) shares concerning data about the experiences of doctors and the challenges to providing adequate care to patients. In this context, careful and constructive exploration of the practical, evidence-based steps that can be taken to improve the situation is critical – to protect both patients and the doctors who care for them.
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Content ArticleThere have been significant developments in patient safety over the last decade. But there is a concerning disconnect between increasing activity and progress made to embed a just and learning culture across the NHS. Recognising the challenging operational context for the NHS, this report from the Parliamentary and Health Service Ombudsman (PHSO) draws on findings from their investigations. It asks what more must be done to close the gap between ambitious patient safety objectives and the reality of frontline practice. PHSO identified 22 NHS complaint investigations closed over the past three years where they found a death was – more likely that not – avoidable. It analysed these cases for common themes and conducted in-depth interviews with the families involved.
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Fighting Fatigue Together campaign
Patient Safety Learning posted an article in Staff safety
Fighting Fatigue Together is a network of healthcare organisations working on European, national and local levels brought together by the European Patient Safety Foundation, an in dependent foundation of public interest. They share a common concern for the well-being and safety of healthcare workers. Fatigue is affecting the well-being and safety of healthcare professionals with greater intensity and on a larger scale than ever before. Fatigue is also a risk to patient safety. Patient Safety Learning is one of the organisations that supports this campaign. Visit the Fighting Fatigue Together website to join the campaign. -
Content ArticleThe NHS in England’s annual budget is £161 billion. Yet across the sector there is huge cause for concern, including the still-growing backlog, workforce issues, the state of the estate and the relentless demand on primary care. In this blog, ex-NHS strategic health authority chief executive Mike Farrar and Health Policy Insight editor Andy Cowper look at how these issues can be tackled to provide an NHS that meets the needs of the population. They cover the following subjects: Politics, policy and prevention System working and pivoting to prevention - how to shift resources Building a compelling case for change Moving towards less top-down-ism Being clear about what an ICS is for Culture change and mindsets shifts Resourcing change
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Content ArticleThe Cynefin® sense-making Framework, brainchild of innovative thinker Dave Snowden, empowers leaders across organizations, governments, and local communities, to work with uncertainty – to navigate complexity, create resilience, and thrive. As Snowden says, “The Framework guides us to make sense of the world, so that we can skillfully act in it.”
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Content ArticleAn article from Roger Kline on the failure of many NHS organisations to create a climate where it is safe for staff to speak up. Roger reflects on the recent report published by the National Guardian’s office which summarises the results from the NHS staff survey completed by over 600,000 staff and highlights the story of a senior manager who tried to speak up and the consequences that followed. Further reading: Still not safe to speak up: NHS Staff Survey Results 2022 (Patient Safety Learning blog)
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Why didn’t you report it? A blog by Emma Walker
Patient Safety Learning posted an article in Good practice
A minor accident makes Emma Walker reflect on the safety culture of the NHS. -
Content Articlehe NHS needs every one of its 1.4 million staff, but nobody is perfect every day of their career. Human factors have a huge impact on staff and patients. After witnessing poor behaviour in the workplace, co-workers are less effective and patients have worse outcomes. An unpleasant working culture also reduces camaraderie in teams and can lead to resignations. This is a vicious cycle of overwork and burnout that the NHS can’t afford. We need to nurture our workforce. In this BMJ opinion article, Scarlett McNally suggests focusing on three areas: expecting a minimum standard of behaviour at all times rather than perfectionism; identifying when intense focus is needed; and building effective teams. The minimum standard should be an expectation of “respect” at all times.
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Content ArticlePsychosocial support programs are a way for hospitals to support the mental health of their staff. However, while support is needed, utilization of support by hospital staff remains low. This study from van de Baan et al. aims to identify reasons for non-use and elements that are important to consider when offering psychosocial support.
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Content ArticleAn NHS consultant who was sacked after whistleblowing says it was because he raised concerns that “normal birth” ideology was putting the lives of women and babies at risk. Martyn Pitman, a respected obstetrician and gynaecologist, became a whistleblower to prevent “avoidable disasters” in NHS maternity care, but it cost him his career. Pitman lost his job last month after more than 20 years as a consultant at Royal Hampshire County Hospital in Winchester. His bosses cited an “irretrievable breakdown in his relationship with management”. His dismissal caused outrage from hundreds of former patients and doctors’ leaders, who say it highlights an NHS culture of “punishing those who dare to speak out”.
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Content ArticleThe Royal United Hospital Bath NHS Trust project tested different ways to communicate with staff about patient safety, to encourage the reporting of incidents and to promote a learning culture.
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Content ArticleThe publication of a new single, shared improvement approach, ‘NHS Impact’, is an exciting milestone. It reflects recognition, at the highest level in the English NHS, that improvement principles need to be part of the mainstream approach to the challenges facing the sector. Penny Pereira, Q’s Managing Director, considers the new approach, its potential impact and what it means for members and others working to improve health and care in England and beyond.
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Content ArticleGood patient communication strategies are an essential prerequisite for developing an effective NHS patient safety culture and the NHS needs to improve on its efforts, writes John Tingle in an article for the British Journal of Nursing.
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Content ArticleThe NHS Staff Survey is an essential tool for assessing the experiences and opinions of NHS workers in Trusts in England. It also provides valuable insights to help understand the speaking up culture in the NHS. In this report the National Guardian’s Office analyse the results of the 2022 NHS Staff Survey, focusing on questions relating to speaking up.
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Content ArticleThe tragic and preventable death of Ruth Perry, headteacher at a school downgraded by an Ofsted inspection, has sparked calls for a review of regulatory oversight. While safety and quality must be assured, it’s crucial to consider the impact of regulatory inspections on the well-being of passionate workforces facing complex and challenging environments. In this blog, healthcare entrepreneur Vanessa Webb makes the case that as a potential cause of harm to staff, regulatory inspections in public services including healthcare should be subject to Health and Safety Risk Assessments. There should be a systematic process to identify hazards, evaluate the likelihood and severity of harm, and determine appropriate controls to prevent or mitigate those risks.
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Content ArticleHuge issues are facing the UK’s medical workforce: angst among staff, battles for training opportunities, a lack of basic amenities, discrimination, shortages of posts, roles with no career progression, and a failure to support workers asking for pay reviews. In this BMJ opinion piece, Partha Kar says we need fresh leadership to lead basic changes with support from the royal colleges and unions, and other external organisations need to step up now.
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The National Institute for Health and Care Research (NIHR) Evidence Collections draw together evidence from important NIHR-funded and wider research. They aim to help people in policy and practice understand recent important research in a topic area. The most recent Collection is Maternity services: evidence for improvement. In this blog, one of the Collection's authors, Candace Imison, describes how it was framed by the findings from a recent investigation into failings in East Kent Hospitals’ maternity services. She focuses on some key messages from evidence on how to identify poor performance and provide effective board governance and oversight. -
Content ArticleAn infographic shared on LinkedIn by Kenny Gibson, Deputy Director for NHS Safeguarding, on spotting the red flag in colleagues.
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Content ArticleBurnout is a workplace syndrome characterised by three core attributes: 1) energy depletion or exhaustion, 2) a cynical or negative attitude toward one’s job, and 3) reduced professional efficacy. That second attribute, workplace cynicism, may be the least-understood aspect of burnout in part because of its complexity. In contrast to exhaustion and diminished efficacy, whose causes and effects are relatively straightforward, cynicism can be caused by a number of workplace factors, and it can be expressed in a broad range of emotional states and behaviours. Cynicism is dangerous to both individual and organisational health and can also spread rapidly throughout teams through a phenomenon known as “emotional contagion.” It’s possible to improve even deep-seated cynicism — and better yet, to prevent it from infecting your organization in the first place. The author of this Harvard Business Review article offers strategies to help reverse existing cynicism and to create an anti-cynical culture at work.
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Content ArticleWith increasing concerns around the working conditions and psychological wellbeing of staff in the NHS, questions have been raised about how best to support staff wellbeing. Research is clear that wellbeing interventions that target the organisation and staff’s working environment work better than those which focus solely on supporting the individual person. Although it might seem simple to say: “we need to improve working conditions”, the challenge is whether this is possible and, if so, what this actually looks like in practice.
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Content ArticleThe NHS in England has largely relied on a human resources trilogy of policies, procedures and training to improve organisational culture. Evidence from four interventions using this paradigm—disciplinary action, bullying, whistleblowing and recruitment and career progression—confirms research findings that this approach, in isolation, was never likely to be effective. Roger Kline proposes an alternative methodology, elements of which are beginning to be adopted, which is more likely to be effective and to positively contribute to organisational cultures supporting inclusion, psychological safety, staff well-being, organisational effectiveness and patient care.
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NHS Impact resources
Patient Safety Learning posted an article in NHS England
NHS Impact ‘improving patient care together’ is the term NHS England is using for the new single, shared NHS improvement approach. This includes the five components which form the ‘DNA’ of all evidence-based improvement methods, which underpin a systematic approach to continuous improvement: Building a shared purpose and vision. Investing in people and culture. Developing leadership behaviours. Building improvement capability and capacity. Embedding improvement into management systems and processes. When these 5 components are consistently used, systems and organisations create the right conditions for continuous improvement and high performance, responding to today’s challenges, and delivering better care for patients and better outcomes for communities. -
Content Article
Why are doctors so unhappy? (BMJ, 5 May 2001)
Patient Safety Learning posted an article in Culture
Doctors are unhappy. They are not all unhappy all the time, but when doctors gather, their conversation turns to misery and talk of early retirement. The unhappiness has been illustrated in a plethora of surveys and manifests itself in talk of a mass resignation by general practitioners from the NHS. The British government is rattled by the unhappiness of doctors, recognising that a health service staffed by demoralised doctors cannot flourish. It has responded by trying to hand more control of the service to frontline staff. But is this the right treatment, asks the BMJ's Editor Richard Smith. -
Content ArticleThe latest NHS Workforce Race Equality Standard (WRES) data shows that it is still over twenty times more likely that a White Band 5 nurse will become a Director of Nursing compared to a Band 5 BME nurse. In this letter Roger Kline, Research Fellow at Middlesex University Business School, outlines his concerns about discrimination and bullying taking place within the NHS. Addressed to Secretary of State for Health and Social Care Steve Barclay, the letter recalls the findings of the Messenger report commissioned by Mr Barclay's predecessor Sajid Javid, which found that “acceptance of discrimination, bullying, blame cultures and responsibility avoidance has almost become normalised in certain parts of the system, as evidenced by staff surveys and several publicised examples of poor practice." Referring to recent calls to reduce spending on equality, diversity and inclusion (EDI), he outlines why patient care and frontline services cannot be detached from efforts to improve EDI. He argues that research strongly suggests how staff are treated (including whether they face discrimination) impacts on patient care, staff well-being and organisational effectiveness.
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