High proportion of NHS staff feel swift and effective action is not taken to deal with inappropriate behaviours, new survey finds

Two fifths (43 per cent) of NHS staff feel that swift and effective action is not taken to deal with inappropriate behaviours and performance in their organisation, a survey published today by The King’s Fund has found.

The survey of more than 2,000 NHS clinicians and managers also found that a noticeable proportion of executive board members (16 per cent) did not think that swift and effective action is being taken, with only 58 per cent thinking that it is. Dealing with inappropriate behaviour effectively is an important process to ensure the right cultures are fostered which will deliver high-quality, patient-centred care. However, the vast majority (89 per cent) of NHS staff believe that patient feedback is encouraged in their organisation, with 61 per cent feeling that patient feedback will be acted upon.

The survey, conducted for the second year in order to understand leadership, culture and compassionate care in the NHS, also revealed a consistent disconnect between the views of executive directors and other NHS staff, especially nurses and doctors. Executive directors tended to be much more positive about the working environment and culture within their organisations than other staff, especially nurses. For example, 63 per cent of executive directors believe that there is a pride and optimism among staff, as opposed to only 20 per cent of nurses and 22 per cent of doctors felt the same.

This lack of consensus is a cause for concern. In two reports published today, The King's Fund, working with the Center for Creative Leadership, a top ranked executive education provider worldwide, argue that to develop better cultures of care the NHS should promote collective leadership, where everyone takes responsibility for the success of the organisation as a whole. This requires high levels of dialogue, debate and discussion to achieve a shared understanding. 
Only 39 per cent of NHS staff felt that their organisation was characterised by openness, honesty and challenge. Creating cultures of openness and honesty was a key recommendation made by Sir Robert Francis in his inquiry into the failings in care at Mid Staffordshire NHS Foundation Trust, and linked to compassionate care.

Nicola Hartley, Director of Leadership Development, The King's Fund said:

'The survey reveals a mixed picture of leadership and compassion in the NHS. The disconnect between the views of executive directors and other staff, especially nurses and doctors, is cause for concern. It is important that NHS organisations engage in dialogue and debate to achieve a shared understanding of the challenges they face and what the solutions are. Creating truly compassionate patient services requires collective leadership, where all staff take responsibility for the success of the organisation and that this is actively promoted by leaders in the organisation. All NHS organisations should make creating a collective leadership strategy a priority.'

Over the past year, there has been clear improvement in how NHS staff view the quality of leadership in the NHS. 22 per cent of respondents thought quality of leadership was 'good' or 'very good', up from 14 per cent in 2013, while 28 per cent of NHS staff felt the quality of leadership was poor or very poor, down from 40 per cent in 2013.

More on the survey and collective leadership

Notes to editors: 

For further information, for a copy of the survey overview or for interviews, please contact the Fund's Press and Public Affairs team on 020 7307 2603 (if calling out of hours, please ring 07584 146035) or by mediaoffice@kingsfund.org.uk.

The survey of NHS staff included questions relating to leadership, care and culture. It was open from February to March and carried out in partnership with Managers in Partnership, NHS Professionals, the Royal College of General Practitioners (RCGP), the Royal College of Midwives (RCM), the Royal College of Nursing (RCN), the Royal College of Physicians (RCP), the Royal College of Surgeons (RCS) and the Faculty of Medical Leadership and Management. The partners distributed the survey among their membership. This is the second year that the survey was conducted by The King’s Fund and its partners, although only a few questions were repeated.

To view the survey results in full please use the following link: www.kingsfund.org.uk/leadershipsurvey2014

The survey is being published to coincide with the fourth annual leadership summit at The King's Fund. Alongside this, two reports on collective leadership are published here www.kingsfund.org.uk/collectiveleadershipdelivery and here: www.kingsfund.org.uk/collectiveleadership

The King's Fund is working in partnership with the Center for Creative Leadership to support NHS organisations to design and deliver collective leadership strategies that will promote cultures where compassionate care for patients is prioritised.

The Center for Creative Leadership (CCL®) is a top-ranked, global provider of leadership development. By leveraging the power of leadership to drive results that matter most to clients, CCL transforms individual leaders, teams, organizations and society. Our array of cutting-edge solutions is steeped in extensive research and experience gained from working with hundreds of thousands of leaders at all levels. Ranked among the world's Top 5 providers of executive education by Financial Times and in the Top 10 by Bloomberg BusinessWeek, CCL has offices in Greensboro, NC; Colorado Springs, CO; San Diego, CA; Brussels; Moscow; Addis Ababa; Johannesburg; Singapore; New Delhi-NCR; and Shanghai. www.ccl.org 

The King’s Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.