Trevor Dale, an expert in human factors training, believes that the NHS still has a long way to go in creating a ‘just culture’, where organisations learn from mistakes, human factors are understood, and hierarchy is flexible. So, what exactly does a ‘just culture’ look like?
After more than 15 years of trying to get ‘human factors’ taken seriously by all healthcare professionals, both NHS and private, it seems that change may be on the way. There are organisations that continue to achieve excellence and they are beacons of hope, although they are still a small minority. They have all utilised an understanding of human factors ergonomics principles as a core, blended quality improvement science. They understand that having people at the heart of everything they do is vital. Those people are patients and of course all the staff. So, where does that leave the remainder?
The NHS Patient Safety Strategy,1 published in July 2019, states that human factors training will become part of all mandatory medical education. This happened in aviation Worldwide in 1995. Of course, now we will have the wrangling over the content of the general and specific curriculum. Put simply, if people understand how we all make mistakes then we can learn how not to – or at least reduce the risk. We might also take on board that abusive behaviour, incivility and downright bullying radically increases the propensity for making errors. Perhaps some managers will even bite the bullet and put a stop to bullying behaviour – starting by a good hard look in the mirror.
The General Medical Council has just published Caring for doctors, Caring for patients: How to transform UK healthcare environments to support doctors and medical students to care for patients. It is freely available from the GMC website.2 In 2018, the General Medical Council asked Professor Michael West and Dame Denise Coia to carry out a UK-wide review into the factors which impact on the mental health and wellbeing of medical students and doctors.
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