NHS culture change will take ‘hard HR’

A more open, transparent culture will challenge perceptions that the NHS ‘lacks compassion’, says Dean Royles

Compassion. A word who's closest neighbour is love. A word we want to hear when those close to us are in need of care and a word that has been said more than any other in the NHS its 65th year.

Unfortunately in repeating it, it has nearly always come after the words 'a lack of'.

The phrase ‘a lack of compassion’ has been used to sum up the NHS.

It may not be fair that the events in one hospital more than five years ago have come to define the NHS but that's the reality. And as the dust settles on the government's response to the Francis report, it is clear the implications will be groundbreaking and change the way we work. And it will involve ‘hard HR’.

If you read any HR text book, there is what is known as 'soft' and 'hard' HR. The sort of work some academics refer to as 'hard HR'– pay, pensions, terms and conditions, redundancy. Whereas 'soft HR' is culture, leadership and values etc.

You can see it’s the so-called 'soft' stuff that is in actual fact the hard stuff. The response to the Francis report is about substantial organisational change, it’s about taking the recommendations and making them work in practice and, more importantly, it’s about supporting staff through the myriad of changes it will spawn. I've said before that it is probably the world's biggest OD challenge.

The headlines from the response focused on criminal sanctions, fit and proper person tests and losing insurance cover. But the government's response also highlighted the importance of effective teamwork, staff contributions, engaging and empowering staff, and creating a supportive culture where staff feel able to speak up, challenge and take forward changes for the benefit of patients. We know that is how we drive safe, compassionate care.

There is absolutely no place for poor standards of care anywhere in the NHS. But working in a climate of blame and fear is not good for staff. Frontline employees see what happens on the ground - both good and bad - and must not be afraid to speak out.

The professional duty of candour announced in the response will help facilitate that. All the surveys tell us that staff can and do raise concerns, we need to be much better at feeding back what happened and giving staff support and praise for highlighting concerns.

Building on work it has already started, NHS Employers is working to introduce three initiatives to help organisations support staff in improving and enhancing the delivery of compassionate care. They are: improving wellbeing in the workplace; staff engagement; and organisational development and culture change.

These initiatives cover a range of topics, including helping line managers to support staff with mental health issues, improving manager engagement with staff, and identifying organisations that have used OD techniques to change their culture and improve compassionate care.

There is much work to do, however, I know that organisations are up for the challenge. If we all work together, we can create a better NHS. An organisation which is more open and transparent, that is innovative, looks after its staff, provides compassionate care to patients. We want people to want to come and work in the NHS and make those that already do proud.