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Doctors call for ‘learn not blame’ culture in NHS

NHS must acknowledge and learn in constructive and fair manner when things go wrong

Louise Prime

Tuesday, 20 November 2018

We need a just culture in the NHS in which every individual patient and staff member is valued and cared for, doctors have demanded this morning. At the launch in Westminster of their "Learn Not Blame" campaign, The Doctors’ Association UK (DAUK) lobbied for a revolution in NHS culture to one that celebrates professionals’ success and good work, and also “acknowledges and learns in a constructive and fair manner when things go wrong”.

DAUK said its members are campaigning for the NHS culture to become one that “promotes learning from adverse events and prioritises fairness, openness and the wellbeing of both patients and health care professionals”, but argued that this can only happen with the creation of a just culture for all. It said it wants to empower doctors and all NHS staff to do what they can within their own sphere of influence to ensure meaningful change and to create a better NHS to work in – and a better NHS for patients”.

Scott Morrish, whose three-year-old son Sam died eight years ago from sepsis after ‘a catalogue of errors’, was also at today’s campaign launch. He told BBC Radio 4’s Today programme earlier this morning that the whole system failed his son, rather than a single individual, and a large number of failures contributed to his death. He explained that after Sam’s death his focus and greatest need was purely to understand what had happened.

Yet, he said: “I didn’t get the sense that anything was happening, other than denial. … it was very much a case of just pretending this thing hadn’t happened, and effectively hiding from it.” He said he spent six years in a complaint system “that felt like torture”, and he believed that this was equally unjust for the GPs, consultants and nurses on the other end of that system. He said: “It was unnecessary and it was caused by the fact that the system just would not hold itself accountable for what was happening – not in terms of blame, just in terms of truth, honesty, learning and improvement.”

DAUK’s campaign lead Dr Cicely Cunningham responded on the programme that its purpose was not to protect doctors, but to encourage them to take responsibility for their behaviours and to make whatever changes they can. She said: “Every doctor has more influence than I think they know.” She argued that, at work, bad behaviour and incivility affect performance and that this in turn affects patient safety.

She went on: “We want to change the culture of the NHS and make it into a kinder, more compassionate place where every individual does very simple things like introducing themselves when they’re starting a conversation with a new colleague, where they thank their colleagues for things that they’ve done when they’ve gone ‘over and above’, and also that they look after their colleagues and ask how they’re doing.”

She pointed out that patients in a practice or on a ward perceive the prevalent culture within that organisation, and noted that: “At present we’re all too quick to lay blame and to bully – this is something that we really need to address.”

At today’s launch, DAUK said it is campaigning for a major change from the prevalent blame culture in the NHS when things go wrong, often without any learning taking place. It said: “In this campaign, we are coming together to say: ‘Enough. This has to stop.’

“What we need is a just culture in the NHS, where every individual – whether patient or staff – is valued and cared for. We need to develop a culture that celebrates success and the good work of thousands of professionals, but one that also acknowledges and learns in a constructive and fair manner when things go wrong.”

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