ArticleJournal of the Royal Society of Medicine2019
Senior stakeholder views on policies to foster a culture of openness in the English National Health Service: a qualitative interview study.
Article in Journal of the Royal Society of Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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Who cites it
6 citing papers in PubMed.
- Encouraging openness in health care: Policy and practice implications of a mixed-methods study in the English National Health Service.Journal of health services research & policy · 2023Article
- Open organisational culture: what does it entail? Healthcare stakeholders reaching consensus by means of a Delphi technique.BMJ open · 2021Article
- Openness in the NHS: a secondary longitudinal analysis of national staff and patient surveys.BMC health services research · 2020Observational
- NHS Improvement's Just Culture Guide: good intentions failed by flawed design.Journal of the Royal Society of Medicine · 2019Review
- The Mixed-Method 5W2D Approach for Health System Stakeholders Analysis in Quality of Care: An Application to the Moroccan Context.International journal of environmental research and public health · 2019Article
- The German Ethical Culture Scale (GECS): Development and First Construct Testing.Frontiers in psychology · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectivesTo examine the experiences of clinical and managerial leaders in the English healthcare system charged with implementing policy goals of openness, particularly in relation to improving employee voice.
designSemi-structured qualitative interviews.
settingNational Health Service, regulatory and third-sector organisations in England.
participantsFifty-one interviewees, including senior leaders in healthcare organisations (38) and policymakers and representatives of other relevant regulatory, legal and third-sector organisations (13).
main outcome measuresNot applicable.
resultsParticipants recognised the limitations of treating the new policies as an exercise in procedural implementation alone and highlighted the need for additional 'cultural engineering' to engender change. However, formidable impediments included legacies of historical examples of detriment arising from speaking up, the anxiety arising from increased monitoring and the introduction of a legislative imperative and challenges in identifying areas characterised by a lack of openness and engaging with them to improve employee voice. Beyond healthcare organisations themselves, recent legal cases and examples of 'blacklisting' of whistle-blowers served to reinforce the view that giving voice to concerns was a risky endeavour.
conclusionsImplementation of procedural interventions to support openness is challenging but feasible; engineering cultural change is much more daunting, given deep-rooted and pervasive assumptions about what should be said and the consequences of mis-speaking, together with ongoing ambivalences in the organisational environment about the propriety of giving voice to concerns.
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Registered trials
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