Workforce issues
in April 2026 and data will be published at the employer level every quarter. Unions and employers will be included in the discussions to review, update and reform employment contracts and start a big conversation on significant contractual changes that provide modern incentives and rewards for high-quality and productive care. One of the specific elements which is being
tackled is to try to reduce the sickness and absence rate from its current level of 5.1%, which puts great strain on local clinical areas.
Cultural change Focus on developing a positive working environment, one where quality and safety are the most important values demonstrated is required; otherwise reform, as outlined in the 10-Year Plan, will not be able to be delivered. The experiences of the workforce will need to be good ones when asking them to adapt to the changes envisaged. The present command and control management structures will not enable the changes to be made and, while there has been encouragement from NHS England, in the recent past, to nurture the workforce and to show kindness to them, the other operational and structural stresses on the system have not demonstrated this in many Trusts. It is worth reviewing the values described in the NHS Constitution. The words have all been written and accepted in the past, but it is not the lived experience of many who now work in the NHS. The values outlined include respect, dignity, compassion, integrity, inclusion and excellence, and they play a pivotal role in team culture not only among the workforce, but also towards patients. In short, the main values of the constitution amount to: Alignment of behaviour and mission l NHS values provide a common framework guiding how staff interact with colleagues, patients, and stakeholders.
l Teams operating under these shared values
develop coherent practices that reflect the organisation’s mission, ensuring consistency in care delivery.
Enhancement of communication and collaboration l Values of honesty, transparency, and open dialogue encourage team members to communicate freely, share information, and constructively challenge one another.
l This reduces misunderstandings, strengthens interprofessional relationships, and contributes to improved patient outcomes.
Cultivation of mutual respect and inclusion l Emphasising respect, dignity, and inclusion builds trust among team members, creating a psychologically safe environment.
l Diverse perspectives are encouraged, and staff feel empowered to contribute, enhancing problem-solving and innovation.
Reinforcement of ethical practices l Values such as integrity and compassion guide ethical decision-making, ensuring patient-centred approaches and adherence to professional standards.
l Ethical practices embedded in team culture enhance trust, credibility, and professional conduct.
Promoting learning and innovation l NHS values foster continuous improvement,
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encouraging teams to reflect on errors, gather feedback, and implement innovations.
l Compassionate and inclusive environments support experimentation and adaptation, driving better care outcomes.
Leadership influence in embedding values l Leaders who model values consistently influence team norms and behaviour, reinforcing a culture of collective responsibility.
l Programmes like the NHS Culture and Leadership Programme have shown that embedding values through engagement, coaching, and change agents enhances staff satisfaction and reduces turnover.
Systemic effects on team culture l NHS values extend beyond individual teams to influence organisational culture, creating coherence across subcultures, reducing counterproductive behaviours such as bullying, and promoting psychological safety.
l Values: driven teams are more likely to exhibit supportive behaviours, collaboration, and a collective focus on safe, high-quality patient care.3
The cultural blueprint should shape the way that teams interact, problem solve and uphold standards but, since the tsunami of COVID-19, many of these standards have fallen by the wayside under the pressure of workload.
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