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Showing results for tags 'Organisational culture'.
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News Article
Culture progress sees NHS Highland escalation eased
Patient Safety Learning posted a news article in News
NHS Highland will no longer receive extra government support in leadership, governance or culture, following improvements after the Sturrock review. The board was initially escalated to Stage 3 of NHS performance escalation framework in 2018 following concerns of a culture of workforce bullying and harassment. An independent report by John Sturrock QC, commissioned by the Scottish government, confirmed “fear, intimidation and inappropriate behaviour” and called for wide-ranging changes. The Healing Process was created in response, with an independent review panel established to speak to victims of bullying and come up with recommendations for the health board to make improvements. A total of 272 current and former NHS Highland and local health and social care partnership staff provided testimony between 2019 and March this year, with more than £2.8m paid out to those affected by bullying. Concerns were raised by some of the first people to go through the healing process that the system was “broken” and many victims could end up “bitterly disappointed”. The board has also established systems and processes to allow colleagues to speak up in the wake of the Sturrock Review, including an independent Guardian Service and staff training in Courageous Conversations. NHS Highland was handed oversight of its own escalation and de-escalation, rather than a Scottish government-led oversight group, in November 2021. Following a letter of assurance from the board chair earlier this year, the Chief Executive of NHS Scotland, Caroline Lamb, agreed to the de-escalation in September. Independent progress tracking shows the board has delivered significantly against many actions laid out by the review but the board concluded in its final June update that ‘culture change is not yet embedded at all levels of our organisation’. Read full story Source: Health and Care Scotland, 2023 -
Content ArticleJames Titcombe, Melanie Leis, and Peter Howitt delineate the major themes of a roundtable to address challenges in improving patient safety, emphasising the need for data sharing nuances, cultural shifts, optimising limited resources, prioritising workforce plans, and staff well-being.
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News ArticleWomen in labour at a London maternity unit deemed “inadequate” were left alone with unsupervised support workers who were not given any guidance, an NHS safety watchdog has found. In a scathing report of North Middlesex Hospital’s maternity services, the Care Quality Commission also found examples of delays to induction of birth for women, and one case of a woman with a still-born baby who was left waiting for the unit to call her in for an induction. Inspectors have downgraded the maternity unit from “good” to the lowest possible rating “inadequate” following an inspection earlier this year. Staff reportedly told inspectors they felt they were “criticised” or “bullied” when reporting safety incidents within the unit. “We heard that the criticism or bullying was worse if the incident reported was relative to other staff and their perceived behaviours,” the report said. There was also evidence the hospital was not recording the severity of safety incidents correctly for example two “never events”, which are among the highest category incidents, were categorised as “low harm”. Other findings included women and babies came to harm as the hospitals did not follow standards to language interpretation despite covering a higher than average minority ethnic population. Read full story Source: The Independent, 11 December 2023
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News Article
Black Country doctors back vote of no confidence in management
Patient Safety Learning posted a news article in News
Doctors at a Black Country mental health trust have backed a vote of no confidence in their management team. Sources say that the Black Country Healthcare NHS Trust is not acting in the best interests of patients and they believe it wants to cut beds. They also have no confidence in the way that the trust has removed its chief medical officer, Mark Weaver. The NHS Trust said it was aware of concerns and had agreed to work on them going forward. The doctors wrote to the trust board following a meeting of the Medical Advisory Committee claiming that over the past two years the relationship with the board had become fractured. In the letter they claimed the voice of doctors was not being taken seriously by the board and that clinical priorities were secondary to financial performance. They also said they were seriously disturbed with the way in which Mr Weaver had been asked to step down and that the deputy chief medical officer Dr Sharada Abilash had not been asked to take over while due process occurred. Read full story Source: BBC News, 9 December 2023 -
Content ArticleLucy Letby was allowed to continue working with new-born babies despite her colleagues raising concerns about her for months. Her conviction highlighted how NHS executives put the reputation of the Countess of Chester NHS Trust ahead of patient safety. But what happened in Cheshire was far from a one-off. File on 4 hears from doctors with unblemished medical careers who were sacked after raising patient safety concerns. The programme follows one medic through an Employment Tribunal as he attempts to save his career, and hears the emotional, brutal toll the process takes on him. For the first time, a top doctor who won record damages talks about the extraordinary steps her managers took to undermine her. Their tactics included relocating her to an empty office with a broken chair and telling colleagues that she agreed with their assessment she was incompetent. And a former NHS executive tells the programme that trusts are more interested in “flying LGBT flags” than tackling concerns about patient safety. With widespread calls for NHS managers to be regulated, File on 4 asks who should take on the role, given the willingness of the NHS to redeploy managers found to have ignored patient safety concerns, or even punished those who dared to raise them.
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Content ArticleMartha Mills was 13 when she tragically died due to a series of medical errors. In this video by the Patient Safety Movement Foundation (PSMF), Martha's mother Merope Mills tells her story and aims to raise awareness about the consequences of medical errors. Merope advocates for improved patient safety measures including the introduction of Martha's Rule, which will allow patients and their families to trigger an urgent clinical review from a different team if they are in hospital, are deteriorating rapidly and feel they are not getting the care they need.
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Content Article
The power of civility in healthcare (3 February 2020)
Patient Safety Learning posted an article in Culture
Dr Chris Turner, of Civility Saves Lives and consultant in emergency medicine, was invited by the NHS Highland Medical Education team to lead a series of lectures and workshops exploring the impact of our behaviour on our colleagues and workplace. -
Content ArticleIn this study, Westbrooke et al. identified individual and organisational factors associated with the prevalence, type and impact of unprofessional behaviours among hospital employees. The study found that unprofessional behaviour is common among hospital workers. Tolerance for low level poor behaviour may be an enabler for more serious misbehaviour that endangers staff wellbeing and patient safety. Training staff about speaking up is required, together with organisational processes for effectively eliminating unprofessional behaviour.
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Content Article
Duty of candour review: terms of reference (6 December 2023)
Mark Hughes posted an article in Culture
The review into the statutory duty of candour has been established by the Department of Health and Social Care to consider the design of operation of this requirement, assess its effectiveness and make advisory recommendations. The duty of candour is about people’s right to openness and transparency from their health or care provider. It means that when something goes wrong during the provision of health and care services, patients and families have a right to receive explanations for what happened as soon as possible and a meaningful apology. -
Content Article
Developing cultural change in healthcare: Part 2 – by Dawn Stott
Dawn Stott posted an article in Good practice
In a two-part blog for the hub, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), talks about the strategies that can help you develop cultural change in your organisation. In part one, Dawn set out the steps to develop a programme of change to support you to achieve good solutions. In part two, Dawn gives you tips on how to assess the culture of your organisation and establish a programme of standardisation. -
News Article
NHS trust under investigation accused of hypocritical email to staff
Patient Safety Learning posted a news article in News
The boss of a hospital trust being investigated by police for alleged negligence over 40 patient deaths has been accused of sending a hypocritical email urging staff to have the courage to raise concerns despite the dismissal of whistleblowing doctors. The investigation, Operation Bramber, was sparked by two consultants who lost their jobs after raising concerns about deaths and patient harm in the general surgery and neurosurgery departments of the Royal Sussex County hospital in Brighton. In an email to staff on Friday, the chief executive, George Findlay, said the trust was committed to learning from its mistakes. He said: “When things do go wrong, we must be open, learn and improve together. That openness is how we give people courage to raise concerns and make a positive difference to patient care.” James Akinwunmi, a consultant neurosurgeon who was unfairly dismissed by the trust in 2014 after he raised the alarm about patient safety, said Findlay’s email was “laughable”. He told the Guardian: “Whistleblowers, including myself, have done exactly what he is encouraging in the email and they were sacked for it, so you can draw your own conclusions. I suspect what they are doing is damage limitation. Instead, they should be dealing with surgeons who have been a problem for years.” Another more recent whistleblower, who did not want to be named, expressed incredulity at Findlay’s claim that he wanted to encourage staff to raise concerns. They said: “The email is hypocritical. How can staff have the ‘courage to raise concerns’ after what has happened to those who have? Those brave enough to blow the whistle about patient safety have been sanctioned, lost their job and had their lives destroyed.” Read full story Source: The Guardian, 3 December 2023 -
News Article
Minister: There’s systemic racism in the NHS
Patient Safety Learning posted a news article in News
A health and social care minister privately said there was ‘systemic’ racism within the NHS and called for an investigation into it. Helen Whately told Matt Hancock of her belief in a private message which was today shown to the covid public inquiry. An inquiry hearing with Mr Hancock – who said he agreed with the point – was shown an exchange between Ms Whately, then care minister, and Mr Hancock in June 2020. The Guardian had reported the previous day that an internal report had found systemic racism at NHS Blood and Transplant. Ms Whately, who is now minister of state covering social care and urgent and emergency services, said: “I think the Bame next steps proposed are important but don’t go far enough. There’s systemic racism in some parts of the NHS, as seen in NHSBT.” She added: “Now could be a good moment to kick off a proper piece of work to investigate and tackle it.” Read full story (paywalled) Source: HSJ, 1 December 2023 -
Content ArticleThe first 14 minutes of this programme are focused on a Newsnight investigation into allegations of cover-up, avoidable harm and patient deaths relating to University Hospitals Sussex NHS Foundation Trust. At the time of broadcast, Sussex Police were investigating 105 claims of alleged medical negligence at the Trust.
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Content ArticleHospital leaders need to embed a safety culture across their organisations - read the latest guest blog on the Patient Safety Commissioner website from Maria Caulfield, the minister for mental health and women's health strategy. Maria gives three examples of how we are advancing patient safety across our NHS.
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Content Article
Developing cultural change in healthcare: Part 1 – by Dawn Stott
Dawn Stott posted an article in Good practice
If we are to continue improving healthcare services, then developing cultural change in healthcare is crucial. Improving the quality of care, reducing medical errors and, ultimately, enhancing patient outcomes is essential for the future. Transforming the culture within healthcare organisations requires a comprehensive approach that involves leadership commitment, employee engagement, continuous education and a focus on patient-centred care. In a two-part blog for the hub, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), talks about the strategies that can help you develop cultural change in your organisation. In part one, Dawn sets out the steps to develop a programme of change to support you to achieve good solutions. -
Content ArticleProductivity is misunderstood at every level in the NHS, not least because the leadership so often use the word to mean something entirely different. So what is it and what are the big misunderstandings about it? In his LinkedIn post, Stephen Black discusses what productivity is and what misunderstandings are feeding the problem.
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Content ArticleThe healthcare workplace is a high-stress environment. All stakeholders, including patients and providers, display evidence of that stress. High stress has several effects. Even acutely, stress can negatively affect cognitive function, worsening diagnostic acumen, decision-making, and problem-solving. It decreases helpfulness. As stress increases, it can progress to burnout and more severe mental health consequences, including depression and suicide. One of the consequences (and causes) of stress is incivility. Both patients and staff can manifest these unkind behaviours, which in turn have been shown to cause medical errors. The human cost of errors is enormous, reflected in thousands of lives impacted every year. The economic cost is also enormous, costing at least several billion dollars annually. The warrant for promoting kindness, therefore, is enormous. Kindness creates positive interpersonal connections, which, in turn, buffers stress and fosters resilience. Kindness, therefore, is not just a nice thing to do: it is critically important in the workplace. Ways to promote kindness, including leadership modelling positive behaviours as well as the deterrence of negative behaviours, are essential. A new approach using kindness media is described. It uplifts patients and staff, decreases irritation and stress, and increases happiness, calmness, and feeling connected to others.
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Content ArticleThe latest Care Quality Commission (CQC) report on the state of care in England is far from an encouraging read.1 Although the healthcare system is under serious strain, maternity services are among the areas identified as especially challenged. The problems identified in maternity care, while shocking, come as no surprise. The sector is seeing repeated high profile organisational failures and soaring clinical negligence claims, together with grim evidence of ongoing variation in outcomes, culture, and workforce challenges and inequities linked to socioeconomic status and ethnicity. In this BMJ Editorial, Mary Dixon-Woods and colleagues discuss why it's time for a fresh approach to regulation and improvement.
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Content Article
Thirlwall Inquiry
Mark Hughes posted an article in Other reports and inquiries
The Thirlwall Inquiry has been set up to examine events at the Countess of Chester Hospital and their implications following the trial, and subsequent convictions, of former neonatal nurse Lucy Letby of murder and attempted murder of babies at the hospital. This website provides information about inquiry team, terms of reference and publications relating to this. -
Content ArticleWhistleblowing presentation from Peter Duffy to the Association for Perioperative Practice, September 2022. York University.
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News ArticleThe public inquiry into the Lucy Letby murders will seek changes to NHS services and culture next year despite the fact that formal hearings are likely to be delayed until the autumn. Inquiry chair Lady Justice Thirlwall will issue an update message later today. In it she will stress the inquiry will “look for necessary changes to be made to the system of neonatal care in this country in real time and at the earliest opportunity, avoiding delays in making meaningful change”. HSJ understands Lady Thirlwall will look to agree on some changes, based on the inquiry’s evidence gathering and discussions with the sector before it begins oral hearings – which are unlikely to start for at least a year due to ongoing legal action. Lady Thirlwall will say the legal constraints mean its early work will focus on the experience of families who were named in the cases already heard; and “on the effectiveness of NHS management, culture, governance structures and processes, as well as on the external scrutiny and professional regulation supposed to keep babies in hospital safe and well looked after”. She said, “I want this to be a searching and active inquiry in the sense that it will look for necessary changes to be made to the system of neonatal care in this country in real time and at the earliest opportunity, avoiding delays in making meaningful change”. Read full story (paywalled) Source: HSJ, 22 November 2023
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Content ArticleSurviving in Scrubs have published their first report 'Surviving healthcare: Sexism and sexual violence in the healthcare workforce' is now live. The report is an analysis of 150 survivor stories submitted to their website since they launched in 2022. It details the findings on the incidents, factors and challenges unique to healthcare that permit sexism and sexual violence in the healthcare workforce. The report contains recommendations to healthcare organisations to better support survivors and end these behaviours.
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News ArticlePatient safety is being put at risk by the “toxic” behaviour of doctors in the NHS, the health ombudsman has said. Rob Behrens, who investigates complaints about the NHS in England, warned that the hierarchical and high-handed attitude of clinicians was undermining the quality of care in some hospitals. He called for medical training to be redesigned to encourage a more empathetic and collaborative approach from doctors. Pointing to failings in the treatment of sepsis and the problems in maternity services, Behrens said he was “shocked on a daily basis” by what he saw as ombudsman. Too often, “organisational reputation has been put above patient safety”, he told The Times Health Commission. The ombudsman warned of a “Balkanisation” of health professionals, with rivalries between doctors and nurses or midwives and obstetricians harming patient care. “For all the brilliance of clinicians quite often they’re not very good at working together,” he said. “Time and again, the handover from one clinician to another, from one shift to another, or the inability to raise the issue at a senior level has been a key factor in what has gone wrong.” Read full story (paywalled) Source: The Times, 18 November 2023
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Content ArticleIncivility in the workplace, school and political system in the United States has permeated mass and social media in recent years and has also been recognized as a detrimental factor in medical education. This scoping review in BMC Medical Education identified research on incivility involving medical students, residents, fellows and faculty in North America to describe multiple aspects of incivility in medical education settings published since 2000. The results of the review highlight that incivility is likely to be under-reported across the continuum of medical education and also confirmed incidences of incivility involving nursing personnel and patients that haven't been emphasised in previous reviews.
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Content ArticleThe government recently published terms of reference for the Thirlwall Inquiry following the crimes committed by former neonatal nurse Lucy Letby while working for the Countess of Chester Hospital NHS Foundation Trust. As well as examining the detail of the offences, the inquiry will also probe whether the trust’s culture, management, governance structures and processes contributed to the failure to protect babies. In the wake of this tragedy, it became apparent that staff had sounded the alarm about Lucy Letby, but that their concerns were not acted on. The case has propelled the issue of NHS management structures and the regulation of managers back into the headlines and made it the subject of political debate.
