Changing organisational culture: top tips

Change cartoon

22 / 10 / 2015

Culture change projects driven from both the front line and boardroom are taking root across the country.

Here, four leaders spearheading culture change programmes share their tips for achieving lasting change.

Dawn Jarvis, Director of People and Organisational Development, Doncaster and Bassetlaw Hospitals NHS Foundation Trust

  • Culture is like time – you can’t control it, bend it or change it. You need to make the most of it, creating the right conditions for it to work well.
  • You need a strong strategic narrative for the organisation, integrity among the leadership, engaged staff and enabling managers.
  • An absolute must for creating the right conditions for a healthy culture to develop is having a cohesive leadership team who set and reinforce the right tone and who also involve many others to reach across the organisation.

Heather Tierney-Moore, Chief Executive, Lancashire Care NHS Foundation Trust

Heather Tierney-Moore

  • Collectively define your values as an organisation, consider what living them means in practice and ensure that everything you do is aligned to them. 
  • We need to encourage leadership at all levels, not just for those in senior positions, making the most of the collective expertise across the organisation. Staff need to feel confident in challenging things that are not right and able to have difficult conversations.
  • Chief executives need to have humility in their leadership style and accept that they won’t have all the answers. They should cultivate their curiosity and that of their teams. Asking the right questions is key to understanding the complex issues others are trying to address. Pointing the finger or looking for simple answers is not helpful.

Dr Umesh Prabhu, Medical Director, Wrightington, Wigan and Leigh NHS Foundation Trust

Umesh Prabhu

  • Define trust values by engaging staff – staff engagement is the key to the success of any organisation. Boards must work with their staff to define their values, culture, governance and accountability.
  • Appoint values-based leaders who uphold those values - values-based leaders are role models, kind, caring, compassionate and courageous. They lead by example and lead from the front.
  • Have robust governance and accountability – boards must make sure there is zero tolerance for bullying, harassment, victimisation, naming, shaming, gaming and cover-up, because a happy staff equals happy patients. Ensuring happy staff doesn’t mean that trusts accept poor care or poor behaviour, but instead work with staff to change behaviour and improve quality of care.

James Titcombe, National Adviser on Patient Safety, Culture and Quality, Care Quality Commission

James Titcombe

  • All organisations have issues with quality, but the organisations that achieve the best CQC ratings know where those issues are.
  • Organisations should have an open and safe reporting culture that makes the distinction between recklessness and mistakes.
  • You can’t rely on organisational memory alone: be prepared to consider examples from outside.
  • What is it about the system that makes people so defensive? Attention to detail is crucial, focus on changes to individual behaviours that can in turn influence how others behave.

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