I have the privilege of going round the country talking with people from all backgrounds and all levels in the NHS.
The focus of these conversations is safety. There are three themes that keep coming up.
1. The relentless pressure to increase the number of incident reports together with the consequential investigations is not working. There is no time to do anything else but meet the targets rather than truly learn about what can be done differently. This also means that studying what works is seen as a ‘nice to do if there was time’ rather than actually a way in which we might just get to grips with helping people work safely.
2. There is an urgent need to address and tackle the negative culture. People are experiencing high levels of rudeness, incivility, blaming, shaming, sanctioning and bullying. This is a symptom of the conditions in which people are working; the chronic fatigue, poor diet, overwhelming workload, polarised relationships across professions, poor staffing levels, low morale and the constant struggle to do a good job. It is also a symptom of the punitive governance culture we seem to have fallen into.
3. Morale is really low. People want to be respected, valued, cared for.
This leads to what we should do about it.
Be respectful of each other no matter what our background.
Be kind – it is an unbelievable strength.
Take time to get to know the people around you – you may have no idea what is going on in someone’s life.
Be the leader people want to follow. Support your team. Never be above making the tea, clearing up, being there to help. Listen more than you tell. Say thank you.
These are all lovely things to do but…
this is also the time to say ‘this has to stop’ – to hear students say they are subjected to a toxic culture in the NHS is heart breaking.
This has to stop.
Patient Safety Now 
And the consequences are devastating for individual practitioners and lead to mental health problems, financial ruin, relationship breakdown and even suicide. Not that the DoH even asks coroners to ensure all work-related or work-implicated health practitioner suicide is notified to them. That should be changed immediately. The NMC completely wrecks nurses and midwives lives to no real purpose (patient-safety is their excuse for legalistic, prolonged and punitive torture dressed up as “regulation”). Hundreds of nurses and midwives are lost to the British public every year unnecessarily, as a result of suspensions, sackings and strikings off or endless threats of the same. Thank goodness for blogs like this and people like Sidney Dekker who are challenging this dead-end approach to patient safety.