NHS reforms

04.07.19

Guidance aims to help NHS create environment to better support staff in safety investigations

NHS Resolution has stated that challenging and improving the NHS' workfplace culture is key to improving patient safety in their latest guidance.

The need for the NHS to involve users of care services and staff in safety investigations was highlighted in the newly-released document: Being fair: supporting a just and learning culture for staff and patients following incidents in the NHS

The paper draws on NHS Resolution’s unique dataset to explore best practice in response to incidents resulting from claims from across the system. NHS Resolution received 317 claims, valued at close to £27.5m, in the past four years relating to staff stress and bullying in NHS trusts.

READ MORE: NHS Providers head of policy calls for 'culture shift within NHS' to implement Patient Safety Strategy

This guidance aims to help the NHS to create an environment to better support staff when things go wrong and to encourage learning from incidents. Key challenges include:

  • Fear: The substantial fear of being inappropriately blamed following an incident, the effect on future employment and what peers will think risks preventing NHS staff from sharing and learning.
  • Equity and fairness: Research reveals that there is inequity and discrimination at an individual level and disproportionate disciplinary action is experienced by black, Asian and minority ethnic (BAME) staff, with women making twice as many claims as men.
  • Bullying and harassment: Sadly compound the understandable stress when things go wrong, leading to burnout and a loss of productivity.

NHS Resolution collaborated with organisations including NHS Improvement and Action against Medical Accidents (AvMA), the UK charity for patient safety and justice who supported the creation of a Just and Learning Culture Charter that trusts can adopt.

Dr Denise Chaffer, director of safety and learning at NHS Resolution and one of the co-authors of the guidance, said: “The Being fair guidance encourages a more consistent and equitable approach for all, and is supported by Being Fair charter for all healthcare-related organisations to take forward.

"A just and learning culture balances fairness, justice, learning – and taking responsibility for actions.”

Minister for care, Caroline Dinenage, said: “NHS Resolution’s guidance provides a blueprint for transforming the culture within the NHS to build a more supportive, just and learning environment. It will help create a more consistent approach to investigations when things go wrong, supporting fairer treatment for staff and organisations, enabling them to capitalise on learning and delivering significant benefits to patients.

"To fulfil the ambition in the Long Term Plan to make the NHS the safest healthcare system in the world, we need to foster a more open attitude to patient safety and the ‘Being Fair’ guidance will be an important stepping stone to achieve that.”

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