Julie Burgess on why we must act on staff feedback to improve care
Since the report into failures of care at Mid Staffordshire NHS Foundation Trust was published in March, it has been a topic on the lips of professionals and regulators - and the media. The whole episode has received a lot of airtime and rightly so. But it is now time to move on.
That doesn’t mean we should forget about what happened. We just need to move away from talking about how shocking it is and how such things could be allowed to happen, towards ensuring that we have reflected on our own ways of working and put in place the appropriate changes that we feel are needed, on both an individual and an organisational level.
I would not want anyone reading this to think I am condoning the events at Mid Staffs.
As I read the report, and particularly the sections on nursing, I felt upset that my profession was being talked about in this way.
But I do think it is time to look forward rather than back. We have to remember that not all the staff are bad, nor do they all deliver poor quality care. There are good people who work at the trust, people who deliver high standards of care.
I talked to some of these staff members and they explained how it felt when other people were judging them and not considering their side of the story, and how they felt misrepresented.
‘I have made a commitment to carry on managing by walking about. I know I need to listen and more importantly hear what people are saying to improve care’
The reactions of these colleagues, and their distress at the situation, has made me realise that we must remember and support the people who work in organisations that have been in the public spotlight.
What must it feel like trying to deliver care in an environment that has been slated in such a public way?
We should support our colleagues, make sure we do not judge them, and help them to move on, develop their practice and work hard to improve services.
As a profession, we are often quick to judge when something goes wrong, yet being judgemental does not help matters. Instead, it polarises the situation and often closes our eyes to the good and maybe less obvious things that are happening.
Unless we challenge our thinking and our working practices, we will not make improvements to our care and we will not become safer practitioners.
If something does not feel right we should challenge it. There are many things that occurred at Mid Staffs as well as at Maidstone and Tunbridge Wells NHS Trust that, in retrospect, didn’t look or feel right - so why didn’t the staff challenge them?
I am sure the staff didn’t walk around with their eyes closed - they may have felt something wasn’t right but felt disempowered to challenge what was going on and do something to improve the situation. The key message here is: if it doesn’t feel right, we have to challenge it.
Challenging can be scary. If we are going to challenge we should always give the organisation the courtesy of going through the correct organisational procedures first. That doesn’t mean it needs to be a long, drawn-out process but we should use the policies and procedures in place in an organisation that are there to enable the whistle to be blown.
I have been a whistleblower and it is frightening because once the cat is out of the bag you don’t know what is going to happen. But whistleblowing policies are there to enable such messages to be communicated and ensure the individual is protected.
I once asked an experienced leader who was a nurse and a chief executive about her tips for survival and asked her how she had managed to be successful in a very difficult world. She said: “Always be courageous but always tell the truth. People may not like it but they cannot criticise you for telling the truth. You have to be courageous and, at the end of the day, people will respect you for it even if they don’t like it.”
That is a message I have carried with me and passed on to others because you have to be truthful and courageous if you want to change and improve care.
The revelations about Mid Staffs have made me assess how I function as a leader. I need to listen and hear what people are saying to me. I must listen to all views - from patients, public and staff - in equal measure. I also have to analyse all the information in front of me - what individuals are telling me, messages from complaints, litigation and feedback from other sources. I may not like being told I have to do something to change things but I have to hear the messages and act on them to ensure better services are delivered.
This has really challenged my thinking because, although I believe I’m a good listener, being able to listen to the standard required to avoid situations like Mid Staffs occurring is a tall order. I know that if I am to be an effective leader I have to challenge myself to work to these standards.
I have made a commitment to carry on managing by walking about. I know I need to listen and more importantly hear what people are saying, whether it is a message I want to hear or not. I believe that “active hearing” is the best key I have to improving services in my organisation.
Julie Burgess is chief executive of Heatherwood and Wexham Park Hospitals NHS Foundation Trust