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Call for culture change so NHS managers support staff over errors

Frontline staff must have the support of senior managers if they are to feel confident enough to raise concerns about care, the health service ombudsman has warned.

“Often staff are too scared to acknowledge mistakes because they think it will lead to disciplinary action. This has to change,” Dame Julie Mellor said today in a speech to health service staff.

“Only strong leadership from boards which encourages staff to raise concerns will lead to improvements on wards that we all agree the NHS needs,” she said.

The ombudsman investigates complaints that individuals have been treated unfairly or received poor care from the NHS in England. She publishes an annual report on themes from complaints during the previous year, as well as a range of reports on specific areas – the most recent being on midwifery supervision.

Dame Julie spoke about the importance of actively engaging staff and how this can lead to better outcomes for patients.

She highlighted that patients wanted their concerns to be dealt with there and then and often want a decent explanation as to what went wrong. But she acknowledged that staff needed the support of senior managers and boards to change things in order to make this happen.

“By listening to patients, staff have an opportunity to put things right. Sometimes it’s the small things which staff do or don’t do which makes a difference,” she said. “But frontline staff can’t do this alone, there needs to be a cultural shift in organisations from ‘whose fault is it’ to ‘how can we learn and improve’.”

Dame Julie also spoke about the “enormous potential” for the NHS to learn from complaints and to improve and make a “real difference”. “Complaints are often the first warning sign to show that something is wrong, and a failure to listen and learn can have devastating consequences,” she said.

In addition, she noted that her office was taking on more investigations, in response to public feedback calling for more independent judgements on their complaints.

In 2012-13 her office received almost 16,000 enquiries, of which 377 were judged to require a formal investigation. In the first quarter of the 2013 financial year, the ombudsman had already accepted 450 cases for investigation.

This meant she was able to share more information about what went wrong with different organisations so mistakes could be better avoided in the future, Dame Julie said.

“We… try to spot when there are trends in complaints, such as our recent reports on sepsis and midwifery supervision,” she said. “We share our findings with organisations to help them make public services and the complaints system get better.”

Dame Julie, who has been parliamentary and health service ombudsman since 2012, was speaking today at a 6CsLive! “week of action” event.

The week, organised by NHS England, is focused on working with people to provide a positive experience of care. The event was attended by around 200 NHS staff, including nurses.

 

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Readers' comments (5)

  • michael stone

    Well, again we knew this.

    I think there is currently a police officer who alerted the wider world to the fact that police were 'fiddling their crime figures'. As I understand it, he has given evidence to a group of MPs, but he is also facing police disciplinary procedures for 'bringing the service into disrepute'.

    Until [accurately] publicising failure and wrong-doing CANNOT lead to 'bringing into disrepute' charges, how can progress be made ?!

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  • tinkerbell

    The culture for good or bad is created by management and until this changes there is little hope of any change.

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  • Indeed Michael. If you know beyond all doubt your management will not support you, despite having raised concerns several times, what sane incentive is there to sacrifice yourself, career and family?
    change the management as tinkerbell says AND change the model of working/relationships. I also think the public have to take responsibility for what they are allowing as well. There is enough info in the public arena to make a reasonable informed choice about what health provision you want.

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  • Where I work there is certainly a blame culture with senior nurses working-out who is going to be the scapegoat in real time. It amazes me just how quick some of these office-bound senior staff manage to surface when they can smell a victim.

    If you report any concerns managers always seem to be able to turn it around and blame the person raising it!

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  • michael stone

    Anonymous | 22-Jan-2014 3:16 pm

    'I also think the public have to take responsibility for what they are allowing as well.'

    Have you ever tried, as a member of the public, to explain to something like a hospital/CCB that it is doing something wrong ? Unlike staff, the public cannot get sacked - however, 'the public' typically gets 'the brush off' as being either ill-informed or incapable of understanding the situation !

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