Employers determined to drive forward cultural change

Student nurse caring

22 / 3 / 2013 4pm

The NHS Employers organisation has published its initial response to the Department of Health on the report from Robert Francis QC on the failings in care at Mid Staffordshire NHS Foundation Trust.

The response is based on the views of hundreds of local employers and HR professionals who came together at several listening workshops held in February.
Dean Royles, chief executive of the NHS Employers organisation, said:
“The wholly unacceptable care received by patients at Mid Staffs between 2005 and 2009 shows what happens when organisations collectively fail to focus fully on the core business of providing high quality, safe care.
“Making sure patients are our first priority all of the time and in every organisation will require a relentless focus on culture across the whole system and ensuring a more co-ordinated approach to sharing information across organisations to drive up standards. Developing organisational culture will also require locally driven change and engaging staff fully in the process.
"The 290 recommendations within the report span the breadth of the system and show us how complex delivering and managing high quality care is. As each part of the system looks at its own response we need to be careful we don't get sucked into looking at recommendations in isolation and losing sight of the need to focus on culture. In this case we need to keep our sight on the trees not the wood."
Employers are keen to ensure a healthy balance between national oversight and assurance and what needs to be developed locally. The response says:
  • We must ensure 'top drawer' staff engagement, focusing on supporting and valuing staff;
  • Regulation has a valuable role to play in protecting the public but it needs to mature and develop, use information more intelligently and become more responsive when issues arise;
  • Where policy, legislation and Codes exist but haven't delivered the desired intention, there needs to be a reflection on why this is the case and how they could be made work before creating anything new. This is a generation defining opportunity so we need to get it right. In order to learn lessons from previous investigations and reports we need to accept that local values and ethos are a crucial part of change culture;
  • Building confidence and assurance of the capability of healthcare assistants requires investment of resources into strengthening recruitment, selection, induction and development, rather than the creation of a national register;
  • Embedding values locally, that are owned by staff, will help drive the cultural change required, not an evermore complex development of the NHS Constitution;
  • Locally developed high quality appraisal will help drive standards and behaviour changes across the workforce. This can act as a strong base for assuring professional regulators of an individuals continuing fitness to practise. Employers believe that replicating the medical model of revalidation for nursing is not necessary.
Mr Royles added:

"The feedback we have received shows that there is an unwavering commitment from employers to ensure patients receive high quality care. We will continue supporting them to build upon the good work many have already undertaken around ensuring progressive people management practices, engaging staff, recruiting and managing against locally developed values and creating an open culture where staff feel supported and encouraged to raise concerns.
“There is a lot of great work in the NHS to take forward but variation within and between organisations is a concern. If we can respond in the right way then we can create an opportunity to really transform the care patients receive and the way we go about doing our work. That is the least we owe to the patients and the vast majority of staff who work tirelessly to deliver the highest standards of care. Success will be that 'Francis' becomes a byword for improvement rather than failure."

The NHS Employers letter submitted to Gavin Larner, Director for Professional Standards at the Department of Health, who leads its inquiry team, is available here.

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