Talk Health and Care

Just culture

When I was the medical director of the Trust we removed culture of bullying discrimination and racism and created just culture

1. We appointed kind caring compassionate leaders to each department

2. We made staff and patient engagement is the way we do things

3. We implemented good governance

4. We implemented duty of candour

5 We supported staff to speak up - 70 staff came to meet me in confidence

6 We took action and we protected staff

7. I had to dismiss few bad doctors and also we had to remove few managers and bullying leaders. Some left the Trust and some we had to remove


Just culture means protecting patients. supporting staff to speak up and protecting staff when they speak up and removing bad doctors and bad staff.


Patient safety needs leaders with honesty, sincerity integrity and courage 

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.

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

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

What would be useful in helping develop a just culture?

edited on Feb 21, 2019 by Isabel DHSC
Generic user icon
This comment has been removed

Adam DHSC 3 months ago

Hi Umesh, Thanks for your comments and ideas.

It sounds like you have made good progress. It is impressive to have 70 staff coming to you in confidence - I wonder if you can expand on what you have done to create a culture where staff felt safe to come and speak to you in confidence?

Also - you mention appointing kind and caring leaders - how did you identify who these individuals were?



Reply 0

Umesh Prabhu 3 months ago

Dear Adam the best thing is to chat. My email is

Reply 0