Dr Umesh Prabhu (not verified)

Safety and quality of care for patients is everyone's responsibility and everyone's duty. NHS is very fortunate to have many wonderful staff who are so highly values based and would do anything for their patients even under difficult circumstances. All they need is good leaders and managers who care for staff, kind, compassionate and courageous. NHS needs leaders who inspire staff and not who bully staff.

Sadly NHS has a culture of targets, bullying, harassment, victimisation, discrimination, naming, shaming, disciplining, gaming and cover up. This is purely due to poor leaders at the level of Board who tolerate, accept and in some cases actively promote such a culture because of targets, poor leadership and poor culture and poor governance and accountability.

In Wrightington, Wigan and Leigh FT we have transformed the culture by working with our staff, defining our values, culture and appointed value based leaders and implemented robust governance and accountability for all including Board members. Here is our presentation to CQC Board

I am sure even Health Foundation can see the benefit to patients, staff and the Trust by appointing right leaders based on their values. Until I was appointed as the Medical Director there was not even one BME leader in spite of 50% consultants being BME in the Trust. Today 50% of our medical leaders are BME and 20% are women. They were appointed only for their values and nothing else.

Sadly NHS appoints many poor leaders because of club culture, subconscious bias, Old boys' network and so on. NHS tolerates poor behaviour poor care for long time because of poor governance. In such a culture staff feel demoralised, frightened to talk; patients, staff and NHS suffers.

May be time is right for Health Foundation to come and visit our Trust and see how we have transformed one Acute Trust by appointing right leaders and caring for our staff and with robust governance.

Bridget (not verified)

Great topic and well written. Do you have any more resources about this that you


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Bottoms up is part of the Power of people, our series of films about life-changing health care innovation. 

Our film about Southern Eastern Health and Social Care Trust (SEHSCT) in Northern Ireland shows a range of innovative work to make care better and safer for patients. We look at how people working in the hospital were encouraged and supported to improve patient care, as part of a wider improvement programme (the Safety, Quality, Experience programme - or SQE) which aimed to transform the culture of the organisation. 

In this section we explore the variety of improvement approaches that are being taken across the trust, ranging from an app to help children in care to a checklist designed to avoid people getting acute kidney infection when they are in hospital.

For more information, contact Linda Kelly, Assistant Director for Safe and Effective Care, on