Friday, 17 March 2017

Stop blaming, start learning

You don’t need to go much further than a very interesting report in Community Care to see how the blame culture results in services which are less safe.

A stressed and struggling social worker is reported to have falsified records in order to avoid being publicly named and shamed by her manager. Apparently, the manager circulated a group email to colleagues each week, listing all instances of work which had not been completed within the required time scales.

That blame and fear of blame are the primary enemies of safety is now a well-established fact. Civil aviation has taken this lesson to heart and has devised systems and practices to make it easy for people to talk about their mistakes and failings, so that things can be put right before disasters happen.

Any manager who creates conditions in which members of staff fear to report things going wrong is acting contrary to the interests of her or his organisation and, most importantly, to the interests of those to whom services are delivered. It isn’t just bad practice, it is dangerous practice.

A good introduction to how civil aviation thinking can inform safety debates in health and other fields is provided in a recent ITV programme. Trevor Dale, a former airline pilot, explains how the blame culture works against safety in the NHS. It is well worth half-an hour of your time watching it, if you haven’t done so already.

The overall message is clear: stop blaming, start learning.