Culture unmasked at the best and worst performing NHS hospital trusts

Culture in the NHS
Pulse report 2018

A report published by Pulse UK, finds stark trends in the workforce culture of the best and worst performing hospital trusts. Key findings include staff at ‘inadequate’ hospital trusts being 20% less likely to believe their trust prioritises patient care than at ‘outstanding’ trusts.

The report is based on research of Care Quality Commission (CQC) inspection reports and NHS data. It also finds staff at ‘inadequate’ trusts, when compared to peers at ‘outstanding’ rated trusts, are:

• 20% less likely to recommend their organisation as a place to work or receive treatment
• Less confident in reporting unsafe clinical practice
• Less likely to find the procedures for reporting unsafe clinical practice fair or effective

Commenting, Dennis Bacon, Executive Chairman at Pulse UK, said: “If ever there was a time for NHS providers, arms-length bodies and everyone across the health sector to ‘get serious’ about workforce culture, it is now. We are calling on the system to stop confronting the symptoms of poor culture and start tackling the systemic route causes.”

With culture set to be a central tennet of the forthcoming NHS national patient safety strategy, the report calls for NHS trusts to measure and report their culture in the same way they would report their finances and A&E waiting times to NHS Improvement or the CQC.

The research also finds notable trends in leadership and strategy, with CQC inspectors citing supportive and cohesive leadership teams and a unifying vision and strategy as central to the success of ‘outstanding’ trusts. Meanwhile ‘inadequate’ trusts tolerate high levels of risk to patient safety and suffer from a workforce disconnected from the trust’s vision.

Another significant challenge facing the NHS is the growing turnover of trust executives. The report calls for NHS leaders to be given adequate time to implement change programmes, discouraging quick fixes in favour of getting to the root cause of why a trust may be struggling.

Commenting, the Rt Hon. Patricia Hewitt, Chair, Norfolk & Waveney STP and former Secretary of State for Health, said: “We can all think of too many cases where a trust in special measures has been ‘turned around’ in the short term, only to fall back into problems because the underlying issues – culture, behaviour and leadership – have not been effectively addressed.

“Unless these are tackled through a focus on workplace culture, we will continue to see adverse effects on quality, safety, sickness, retention and productivity. I hope the recommendations in this report will be welcomed by trust leaders and adopted by NHS Improvement.”

Source: Pulse UK