Telling cultures: ‘cultural’ issues for staff reporting concerns about colleagues in the UK National Health Service

Recent UK health policy initiatives promote a ‘no blame culture’ and learning from adverse events to enhance patient safety in the NHS. Similar initiatives exist in the USA and Australia. Changing the ‘blame culture’ in the NHS has been advocated in policy documents and inquiry reports for over a de...

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Bibliographic Details
Published in:Sociology of health & illness 2006-11, Vol.28 (7), p.903-926
Main Author: Ehrich, Kathryn
Format: Article
Language:English
Subjects:
blame
Cultural studies
Culture
errors
Ethics and moral life
Health care
Health care policy
Health Care Services
Health Care Services Policy
Health Policy
Health services
Hospitals
Humans
inquiries
Interprofessional Relations
Medical errors
Medical Errors - prevention & control
Medical personnel
Organizational Culture
Patient safety
Patients
Power (Psychology)
Safety
Safety Management
Sociology
Sociology of health and medicine
Sociology of knowledge and ethics
Sociology of knowledge and sociology of culture
Staff
State Medicine - organization & administration
United Kingdom
Whistleblowing
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Summary:Recent UK health policy initiatives promote a ‘no blame culture’ and learning from adverse events to enhance patient safety in the NHS. Similar initiatives exist in the USA and Australia. Changing the ‘blame culture’ in the NHS has been advocated in policy documents and inquiry reports for over a decade. Some key concepts that are used in the policy discourse –‘blame’; mistakes, errors and misdemeanours; and ‘culture’– are examined and considered in the light of pertinent social science literature to question some of the assumptions concerning these terms in the policy discourse, and to suggest some alternative questions and perspectives. The Three Inquiries, a recent series of statutory inquiries held in the UK, are used as a case study to explore some of the intra‐ and inter‐professional difficulties of reporting errors and misconduct by medical practitioners. The paper offers an interpretive social science perspective as an alternative to more policy oriented and managerial approaches to patient safety issues, focusing on deeper structural aspects of organisational phenomena implicated in the ability or otherwise of medical and other healthcare staff to report mistakes and misconduct as one aspect of patient safety.
ISSN:0141-9889
1467-9566
DOI:10.1111/j.1467-9566.2006.00512.x