About Me

This blog carries a series of posts and articles, mostly written by Anthony Fitzsimmons under the aegis of Reputability LLP, a business that is no longer trading as such. Anthony is a thought leader in reputational risk and its root causes, behavioural, organisational and leadership risk. His book 'Rethinking Reputational Risk' was widely acclaimed. Led by Anthony, Reputability helped business leaders to find, understand and deal with these widespread but hidden risks that regularly cause reputational disasters. You can contact Anthony via anthony.fitzsimmons At cranfield dot ac dot uk

Sunday, 3 March 2013

Shooting Messengers Kills Patients

It's bad enough when an organisation doesn't act on or learn from bad news.  Shooting messengers who bring bad news makes things worse.  The organisation can't learn from the mass of mishaps with minor consequences that vastly outnumber mistakes ending in disaster.

That's what is going on in the NHS, according to the results of a survey in Nursing Times
"84% of [nurse] respondents had previously raised concerns about a colleague’s practice or attitude – of which 23% said they had done so “several times” or “regularly”, and 23% “at least once”.
But of those who had raised concerns, 52% said there had been no appropriate outcome as a result of speaking up and a similar percentage said doing so had led to negative consequences for themselves.
Almost 30% of nurses said being viewed as a troublemaker was the biggest barrier to speaking up, with inaction by managers cited by 23%. "

Organisations that don't learn from their own experience suffer calamitious reputational damage when the public learns that they don't systematically learn lessons from experience.  Their leaders are branded as incompetent at best.  More important, their customers suffer the consequences.  In the NHS, that means avoidable harm to patients, as those so disastrously served by the Mid-Staffordshire Hospitals have learned. It's been estimated that between 400 and 1200 unnecessary deaths occurred there between 2005 and 2008.

This is a deep cultural issue, reinforced by incentives and a long history.  In the past it's been reinforced by government set targets and the systematic  gagging of those who alleged bad practice.  Following the Francis Report, the Department for Health says it want things to change, but changing such a deeply embedded, longstanding and seemingly ubiquitious bad practice is exceptionally hard to achieve.

Anthony Fitzsimmons

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