Many NHS staff feel that swift and effective action is not taken to deal with inappropriate behaviours and performance in their organisation, a survey says.
The King’s Fund poll of more than 2,000 NHS clinicians and managers shows that two fifths (or 43%) did not think action was taken swiftly or effectively enough – with a noticeable proportion of executive board members (16%) in agreement.
Dealing with inappropriate behaviour is an important process to ensure the right cultures are fostered which will deliver high-quality, patient-centred care, the study suggests.
However, the vast majority (89%) of NHS staff believe that patient feedback is encouraged in their organisation, with 61% feeling that patient feedback will be acted upon.
The survey, conducted for the second year in order to understand leadership, culture and compassionate care in the NHS, also reveals a consistent disconnect between the views of executive directors and other NHS staff, especially nurses and doctors.
Executive directors tended to be much more positive about the working environment and culture within their organisations than other staff, especially nurses. For example, 63% of executive directors believe that there is a pride and optimism among staff, as opposed to only 20% of nurses and 22% of doctors felt the same.
Creating cultures of openness and honesty was a key recommendation made by Sir Robert Francis in his inquiry into the failings in care at Mid Staffordshire NHS Foundation Trust, and is linked to compassionate care.
However, only 39% of NHS staff felt that their organisation was characterised by openness, honesty and challenge.
Nicola Hartley, director of leadership development, at the King’s Fund said: “The survey reveals a mixed picture of leadership and compassion in the NHS. The disconnect between the views of executive directors and other staff, especially nurses and doctors, is cause for concern.
“It is important that NHS organisations engage in dialogue and debate to achieve a shared understanding of the challenges they face and what the solutions are. Creating truly compassionate patient services requires collective leadership, where all staff take responsibility for the success of the organisation and that this is actively promoted by leaders in the organisation. All NHS organisations should make creating a collective leadership strategy a priority.”
Over the past year, there has been clear improvement in how NHS staff view the quality of leadership in the NHS – 22% of respondents thought quality of leadership was ‘good’ or ‘very good’, up from 14% in 2013, while 28% of NHS staff felt the quality of leadership was poor or very poor, down from 40% in 2013.
The Royal College of Nursing said the findings were “alarming” however.
Chief executive Dr Peter Carter said: “The Francis report made it clear that leadership and organisational culture are key to providing high quality patient care.
“This survey suggests that some progress is being made but there is still much more that needs to be done to encourage better leadership and working cultures in the NHS.”