Executive directors are far likelier to have an upbeat view of their organisation’s working culture than other staff, such as doctors and nurses, according to research.
This was one of the key findings from a survey of 2,000 NHS staff published today by the King’s Fund think-tank.
The survey revealed a “consistent disconnect” between the views of executive directors and other NHS staff, especially nurses and doctors, the King’s Fund said.
Executive directors tended to be much more positive about the working environment and culture within their organisations than other staff, especially nurses.
For example, 63% of executive directors said there was a “pride and optimism” among staff, as opposed to only 20% of nurses and 22% of doctors.
“The disconnect between the views of executive directors and other staff, especially nurses and doctors, is cause for concern”
Meanwhile, only 39% of NHS staff felt that their organisation was characterised by openness, honesty and challenge – despite the warnings made around these topics in last year’s Francis report into care failings at Mid Staffordshire Foundation Trust.
In addition, the survey found staff thought inappropriate behaviour was not being dealt with effectively or quickly enough in their organisation.
This was the view of 43% of NHS staff questioned and 16% of the executive board members who were surveyed.
Most staff (89%) said they thought their organisation encouraged feedback from patients, while 61% thought the feedback would be acted upon.
The King’s Fund noted that dealing with inappropriate behaviour effectively was an important process to ensure the right cultures are fostered which will deliver high-quality patient-centred care.
Commenting on the survey findings, the fund’s director of leadership development Nicola Hartley said: “The survey reveals a mixed picture of leadership and compassion in the NHS. The disconnect between the views of executive directors and other staff, especially nurses and doctors, is cause for concern.
“Creating truly compassionate patient services requires collective leadership, where all staff take responsibility for the success of the organisation and that this is actively promoted by leaders in the organisation.”
The survey was carried out from February to March in partnership with a range of organisations including the Royal College of Midwives, the Royal College of Nursing, medical royal colleges and several groups representing NHS managers.
RCN chief executive and general secretary Peter Carter said: “There is a worrying discrepancy between the upbeat views of NHS executives and the far less positive perceptions of senior nurses, who are anxious about their organisation’s working culture and are not confident that concerns will be taken seriously.
“Nurses in the NHS are extremely hardworking and dedicated to their patients,” he said. “It is demoralising for them to feel that their organisation isn’t delivering the highest possible standards in patient care.”
He highlighted the importance of health service leaders walking the wards and talking to senior frontline nursing staff.
“It is demoralising for nurses to feel that their organisation isn’t delivering the highest possible standards in patient care”
Professor Norman Williams, president of the Royal College of Surgeons, said it was vital that staff avoided burying their heads in the sand when problems cropped up.
He added that addressing problems swiftly and effectively could prevent a deterioration in care quality.
Professor Williams backed a report accompanying the survey, which called on the NHS to foster better cultures of care by promoting a system of collective leadership in which all staff take on responsibility for their organisation’s success.
He added that it was crucial that worries could be raised and acted upon openly, safely and speedily.