Culture In the NHS, and Inclusion

Agenda About Pulse Our Culture in the NHS Report How it Relates to Inclusion What Can we Do About it Discussion & Questions

About Pulse

01 02 03 04 Methodology CQC Reports All Outstanding and Inadequate Rated NHS Trusts 02 Cross Referenced with Performance Data provided to NHSE 03 August 2018 04

3 Key Areas Strategy & Vision Leadership at all levels Learned Helplessness 3 Key Areas

Best Performing Trusts Correlation Best Performing Trusts Quality Leadership Workforce Culture Poorer Performers Less stable leadership Corrosive Workforce Culture

The Scary Stuff Reporting unsafe clinical practice Prevalence of near misses and errors Reporting errors & near misses Net promoter score Care is my organisation’s priority A&E waiting times Referral to treatment waiting times The Scary Stuff

Strategy & Vision Existence Articulation & Embedding (Behaviours) 88% vs 68% Care of Patients a priority Strategy & Vision

Leadership Empowerment of staff to be solutions focused ‘Do what it takes’ to deliver the best Vs Fractured relationships & Inner circles High turnover of leaders Leadership

Normalisation of poor behaviours Learned Helplessness

Key Drivers Personalisation Entitlement Initiative Fatigue Learned Helplessness

Recommendations Empowerment = Accountability Welcome Complaints Role of Arms Length Bodies Monitor, Measure and Promote Culture

Positive Demonstration of Signature Behaviours Leadership Intentional Culture Positive Demonstration of Signature Behaviours Measures Accountability People Strategy

Leadership Knowledge Emotion Reflection

Link to Inclusion? Common set of behaviours Wise leaders Shared and Common Goals Collective Achievement

So what needs to be done? Collective Achievement Sense of Connection

= A new way we do things around here

01 02 03 04 05 Suggested Approach Pick an issue Ensure the Right People are ‘In The Room’ 02 Agree the process, solution & actions 03 Discuss the behaviours 04 Measure! 05

Conclusion We know culture plays a part Systems and processes only get you so far Behaviours before measures Don’t feed the entitlement beast!