Creating a ‘culture of openness’ in healthcare.

Creating a ‘culture of openness’ in healthcare: how are new policies translating into change in NHS organisations?

Following the report of the public inquiry into sustained problems with the quality and safety of healthcare provided at Mid Staffordshire NHS Foundation Trust in the late 2000s, the government introduced a range of interventions designed to address issues of this kind and improve quality of care across the NHS. Common to many of them was the ambition of changing the culture of the NHS, particularly in relation to openness when things go wrong, learning from mistakes, and constantly improving quality.

But the notion of culture is a nebulous one, and the idea that culture is susceptible to change through top-down policy intervention is itself contestable. In this presentation I will draw on a recent evaluation of the translation into practice of several ‘post-Francis’ policies that have aimed to improve openness in the NHS, examining their reception in NHS organisations and the extent to which they appear to have resulted in change. Highlighting both features of implementation that appear to be associated with improvement and persistent challenges that inhibited their translation, I will highlight some of the necessary conditions for change, and consider the prospects for sustainable impact on values, behaviours and patient experiences around openness and learning.

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