Workforce issues
disrupt team effectiveness and productivity. Following the disastrous events at Mid-
Staffordshire Foundation Trust, Robert Francis commented that ‘there lurked within the system an institutional instinct which, under pressure, will prefer concealment formulaic responses and avoidance of public criticism’ and an institutional culture which ascribed more weight to positive information about the service than to information capable of implying cause for concern’.10 Dixon Woods et al11
found that six key
elements were necessary for sustaining culture of high-quality compassionate care for patients: 1. Inspiring visions operationalised at every level by leaders.
2. Leaders ensuring clear aligned objectives for all teams, departments and individual staff.
3. Supportive and enabling people management.
4. High levels of staff engagement. 5. Leaders focused on learning, innovation and quality improvement in the practice of all staff. 6. Effective team working.
Such cultures are achieved by inclusive leaders who provide a limited number of challenging but manageable priorities.
Conclusion The NHS is a complex set of different organisations, many with strong supportive cultures where one is pleased to work and finds that you are listened to and where you feel able to express your ideas, raise concerns and admit mistakes without fear of being judged harshly. These are appointments which are a joy to work in and staff feel protected, valued and supported. There are other organisations where this kind
of atmosphere is far from the truth. Aggravated behaviour leads to stress and tension, leaving everyone on edge and not sure where the next criticism will come from. These are not happy or safe places to work. If the principles of equality, diversity and inclusion are embedded as the personal responsibility of every leader and every member of staff are taken up, then these toxic cultures could be a thing of the past. But it will require leadership and for it to be mainstreamed as the responsibility of all and for any breaches to be called out straight away. Then we would be able to make significant movement towards reducing the ill wind and abusive behaviours which are the cause of so much pain and suffering.
References 1. Messenger G, Pollard L. 2022. Health and Social care Review: leadership for a collaborative and
inclusive future. Accessed at https://www.
gov.uk/government/publications/health- and-social-care-review-leadership-for-a- collaborative-and-inclusive-future#Overview
2. Dixon Woods M, Baker R, Charles K, et al 2014. Culture and behaviour in the English National health service: overview from a large multimethod study. BMJ Qual Saf, 2014;23:106-15 Accessed at
https://qualitysafety.bmj.com/ content/23/2/106
3. 2020 NHS Staff Survey. Accessed at https://
www.gov.uk/government/statistics/nhs-staff- survey-2020
4. British Medical Journal News. September 2023 Nearly a third of female surgeons have been sexually assaulted by a colleague, survey finds, The BMJ, 2023;382:p2090. https://doi. org/10.1136/bmj.p2090
5. Appleby J, Schlepper L, Keeble E. Research Report. The ethnicity pay gap in the English NHS. The Nuffield Trust Accessed at nuffield-trust-ethnicity-pay-gap-web3.pdf (
nuffieldtrust.org.uk)
6. NHS England June 2023 NHS equality, diversity and inclusion improvement plan. Accessed at
https://www.england.nhs.uk/publication/nhs- edi-improvement-plan/
CSJ
7. Royal College of Nursing. No date. Neurodiversity guidance for Managers. Accessed at https://
www.rcn.org.uk/get-help/member-support- services/peer-support-services/neurodiversity- guidance/nd-guidance-for-managers
8. Ibid 9. NHS Staff Council: Good practice equality, diversity and inclusion training guidance. 2021.
About the author
Kate Woodhead, Technical Editor for CSJ, spent many years working in Operating Theatres in the NHS before setting up her own consultancy business. She was Chair of National Association of Theatre Nurses and President of the International Federation of Perioperative Nurses. In her spare time, she Chairs Friends of African Nursing, a UK based charity.
February 2024 I
www.clinicalservicesjournal.com 17
Accessed at
https://www.nhsemployers.org/ publications/equality-diversity-and-inclusion- training
10. Francis R.2013 Report of the Mid-Staffordshire NHS Foundation. Executive summary. Trust Public Enquiry. Accessed at https://www.
gov.uk/government/publications/report-of- the-mid-staffordshire-nhs-foundation-trust- public-inquiry
11. Ibid
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68
