Talk Health and Care

Equality and Inclusion

A just culture in the NHS and social care will be created when we start to treat everyone as equal i.e. when we start listening without prejudice of who's reporting a safety incident regardless of the 9 protected characteristics. When we create a culture of inclusion, involvement and engagement with all staff groups without bias. My point is basically that we work with very diverse cultures and groups of individuals and we should respond to reporting in a consistent manner not based on who's reporting which happens in most cases. NHS leadership need to be more inclusive and consistent in their approach to incident reporting and responses to strengthen or create a just culture.

Think of a safety incident with a patient or service user where you or a colleague have felt supported and treated in a fair way in your workplace. Explain why you felt this.

Prior to joining CLATTERBRIDGE Cancer Centre I worked in an Acute hospital setting where I was responsible for Learning Disabilities Specialist services. I received a complaint that a learning disability patient had been passed from pillar to post in regards to accessing dental appointment. With support from my learning disabilities nurse specialist we investigated the case to establish what the root cause was; worked in partnership and collaboration with our CCG colleagues and the Dental Specialists for our trust responsible for dental surgical procedures; put a plan in place for the patient; responded to the complaint with our findings a plan. Case was resolved. The learning from this was there was disjointed communication initially which delayed treatment for patient, upset parents due to the pain who then raised a complaint which was resolved taking into account the patient safety and putting reasonable adjustments in the plan.

Now think of a time where you have not felt supported or treated fairly in the workplace. Explain why you felt this.

Where things have not worked so well was when I worked within a mental health acute admission ward and there was a patient safety serious incident. Patient self-harmed by cutting his throat and was found by an HCA who straight away raised an alarm was already applying pressure to wound to reduce blood loss. Staff who were on the afternoon shift had not been to check prior to handing over, therefore, timelines of when this had happened when not adding up. However, ALL staff were suspended the next day; BUT some staff after months of investigation returned into their roles i.e. qualified staff, some were downgraded and some never returned.

This is an example of inconsistencies in decision making around who goes and who stays with a clear blame culture on some staff and not on others rather than blanket response for all and try and analyse what went well, not so well and what could have been done better.

What could have been done differently to make you feel better supported and treated fairly?

Listen to all staff fairly and equally, and make decisions that are fair across the board.

What would be useful in helping develop a just culture?

Learning from incidents and sharing that learning

Engagement and Involvement not on paper but real time engagement with all staff

Communicate, listen and be open and honest especially with decision making

Equality and Inclusion for all.

edited on Jan 24, 2019 by Heather DHSC

Wayne Robson 3 months ago

Hi Tabetha, thank you for your comments. My name is Wayne Robson and I am part of the national patient safety team at NHSI. We agree that all staff reporting patient safety incidents should be treated equally and fairly. We are aware of research that shows how gender and race impact the likelihood of staff being disciplined or suspended, and we hope that the just culture guide helps show how important it is that we treat staff in a fair and consistent manner when care doesn’t go to plan

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