Compassion and collaboration – changing the culture in the NHS

With many people citing the workforce crisis in the NHS as the biggest threat to the success of the Long Term Plan (LTP), we look at the changes needed not only to workforce strategy but also how leadership and culture need to change if the LTP is to have the desired impact.

An unhappy workforce

The NHS has been suffering for years, as the workforce has not grown in line with demand for its services and staff have not been supported adequately, with stress levels high and bullying cited frequently as issues. There are high vacancy rates and departures along with an overstretched and demoralised staff all taking its toll.

The leadership of the organisation is also a challenge, as senior roles within the NHS have become less attractive (pressure to succeed quickly, a blame culture) all having a negative impact on culture and performance.

There has never been a more important time for the NHS to introduce new strategies to turn this around to create an engaged and growing workforce, by creating the right environment for these to flourish. Indeed evidence shows that the quality of care and organisational performance are directly affected by the quality of leadership and the culture that leaders create.

Creating an engaged workforce

The long-term plan proposes the development of a new 'NHS leadership code' setting out the cultural values and leadership behaviours of the NHS, which 'will be used to underpin everything from…recruitment practices to development programmes'.

One of the main themes in all of this is compassion and driving through a culture of compassionate leadership. This means a culture where leaders interact with all levels, from national through to regional. It also means a culture of listening, open conversations, shared understanding, empathy and support to take action and a feeling of collective responsibility to ensure a high quality of care. This is a huge leap from the historic top down approach to leadership.

Another key focus of the LTP is collaboration. The emergence of integrated care systems has brought with it a need for effective collaborations with local care providers and a greater emphasis on team working. The growth in demand for NHS services cannot just be met by GPs so that means utilising multi-disciplinary teams and exploring opportunities to work with social care, pharmacists, physiotherapists to deliver more patient-focused care. Leaders will be encouraged to spend as much time outside their organisations, working with local partners as they do in their own organisations. The silos of old and the ways of working in the Foundation Trust model are going to have to change radically.

Managing expectations

Transforming primary care into a team-based model, introducing better training, increasing pay, growing the workforce, investing in better terms and conditions, finding the right digital platforms are all critical factors in the LTP.

The plan promises that NHS staff will get the backing they need. Funding is only one piece of the puzzle. Good leaders who can create a positive culture and build trust are also crucial. Indeed it has been shown that the crucial factors for organisations to gain an outstanding CQC rating are leadership and culture (In the NHS culture trumps everything – Mutual Ventures, March 2019).

These huge cultural changes will take time to implement and get right and we look forward to supporting our clients during these changing times, to see how we can add more value to them and ultimately to the care that they provide.




Closing the gap (March 2019) – Joint report The King’s Fund, the Nuffield Trust and Health Foundation

In the NHS culture trumps everything – Mutual Ventures, March 2019