Take care of itself…


There’s a word I would cheerfully ban. Knock it right out of the vocabulary of management. I hear it all the time.

The word is culture.

It comes, usually packaged, with; ‘the NHS has to change its culture’. Culture is a dumping ground for all the things we don’t like. Culture of fear, culture of secrecy, culture of discrimination. Culture of faxes.

Let’s try and sort this out…

Culture is simple. There is no mystery about it. My simple definition;

‘… culture is the way

we get stuff done’.

Invariably, we are describing an outcome we are not very proud of.

Despite what organisation developers might tell you, what trainers will tell you and consultants say… you can’t change culture.

It’s an outcome and it’s too late to change it.

You have to change the input and that means changing the climate that people work in.

It is the climate that makes the tall trees grow in the forest and the coral reefs in the oceans.

And, it is what enables organisations to grow and prosper. Where people can grow tall, to their full potential.

Where excellence is recognised and success is celebrated.

How do you go about it?

What we are really talking about is success. Safety, performance, achievement, retention is all a success. To create success you need to have a very clear focus on what success means. You need to believe it, relentlessly aim for it.

Here’s an example.

Your focus is to enable everyone in the organisation to develop and reach their full potential.

If that is true and you mean it, how can you ever have an organisation accused of discrimination?

The answer is… tricky.

You know there are scores of NHS organisations that have similar objectives that are riddled with discrimination.

They say it but they don’t mean it.

When organisations don’t deliver on what they say, it corrodes attitudes and that ends up an outcome… a culture that makes it OK to turn a blind eye to discrimination.

Next a winning strategy.

‘Strategy’ is another word I’m not keen on, but it’ll do for now.

Organisations have to play to their strengths. If you are in an area where it is hard to recruit, often coastal towns and out of the way places, you’ll never win with a strategy that says; We will recruit a full compliment of nurses to make this place safe, blah, blah…’

Everyone knows you’ll never do it and the unwritten understanding will be managers are away with the fairies and the way they do things is bull and lies. The outcome, a culture of mistrust.

However, if you said;

‘…we are in a hard to recruit area so we are going to do everything we can to cherish the staff we are fortunate to have, train them and encourage them and make sure they are happy, safe and supported in their jobs… and look forward to coming to work’

If you say it and do it, you’ll create the right climate. Word will get out and you might find recruitment easier.

The NHS is about to go through another upheaval. I’m no longer a fan of the big-white-board-changes but we have to scrape Lansley off our boots and the changes will be bigger than most people realise.

We have to avoid the corrosive canteen culture that says;

‘They’re always changing stuff, it never works, look at the last time…’

If we said;

‘The way we are working now makes it impossible for organisations to work together, it wastes money and the system gets clogged up.

We have to change how we work together, talk to each other, a focus on the patients and not the system…’

When the LTP gets traction the way we work will change. There’s a big chunk of technology coming and a risk of ‘that’ll never work, culture’.

What is the value proposition for people. ‘What’s in it for me?’ The answer has to be;

‘… we can’t make the job you do any easier, because it’s a tough job but we can make it less difficult…’

The success of organisations is defined by how high you can raise the bar on everyone’s willingness to play their part. Everyone can’t do it if you miss out anyone.

Getting the climate right means the culture will take care of itself.

Have a good weekend.

Contact Roy – please use this e-address – roy.lilley@nhsmanagers.net
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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.