The challenge of culture change in the NHS


Professor Michael West, Lancaster University & Visiting Fellow at the Kings Fund

Presenters & contributors:

Professor Naomi Chambers (workshop coordinator), University of Manchester
Professor Graham Martin, Director of Research, THIS Institute, University of Cambridge
Jeremy Taylor, Director for Public Voice, National Institute of Health Research
Suzie Bailey, Director of Leadership, Kings Fund
Jackie Kilbane, Lecturer in Healthcare Leadership and Management, Alliance Manchester Business School
Deborah Davidson, Senior Fellow, Organisation Development and Leadership, Health Services Management Centre at the University of Birmingham


Session Summary:

Connection, inclusion and compassion are certain, unchanging and provide a safe refuge to deal with what feels frightening and isolating for so many. The challenge set by the Francis Inquiry Report – to create a compassionate, inclusive organisational culture – is now amplified in the Covid19 era.

This session explores, through four linked presentations, the problems and opportunities associated with changing healthcare organisation cultures. The first presentation draws on a recent NIHR funded mixed-methods evaluation of the translation into practice of several ‘post-Francis’ policies that have aimed to improve openness in the NHS, and identifies key conditions necessary for policies to make sustainable impact on culture and behaviour. The second presentation reflects on material from a forthcoming book which will offer unfiltered accounts from patients, carers and healthcare professionals about their good and bad experiences of how care is organised, from birth up to the end of life. Their testimonies indicate the salience of kindness and attentiveness combined with efficiency and competence. Finally, research on the conditions for a culture of openness and for patient-centred services will be presented, alongside findings about how a culture change programme is being implemented in 43 Trusts in England.

Significant and unacceptable variations in the availability of high quality care and in staff wellbeing persist across the NHS and social care, exemplified by very different Covid19 experiences across the sector. How far does this kind of research on culture and these kinds of programme interventions help to gain whole system traction in this important area of laying the conditions for reliably compassionate patient care? What positive cultures are exemplified and how can they be sustained?