HSE hosts conference to implement a Just Culture in healthcare

Tuesday, 23 May 2023

Building a values-based supportive model of shared accountability

Today (Tuesday, 23 May 2023), the HSE hosted a conference to set the organisation on its collective journey towards the implementation of a sustainable just culture. A Just Culture refers to a values-based supportive model of shared accountability, which recognises that:

  • organisations are accountable for the systems they have designed;
  • individual staff members are not held accountable for system failings over which they have no control;
  • acts of deliberate harm are not tolerated.

The event, ‘Building a Just Culture in Healthcare: a HSE Dialogue’, heard from a range of speakers on the importance of a Just Culture in ensuring patient safety, as well as the importance of fair treatment and psychological safety of staff. This lends itself to a more compassionate and restorative health service which we are aiming for.

Bernard Gloster, CEO, HSEsaid: “We are committed to creating a compassionate, just, fair and open culture where our staff are actively encouraged to report incidents or raise issues that pose a risk to the safety of patients. This provides opportunities to learn from such events and supports us in delivering high-quality and safe patient care. A Just Culture also ensures open and honest communication, which helps us build trust among our patients and stakeholders. This is but one dimension of an overall improvement of culture necessary in the HSE and I am committed to that effort both in the public interest and the experience of our staff in their vital work.”

Opening the conference, Dr Colm Henry, Chief Clinical Officer, HSE, spoke about the importance of support for Just Culture at leadership level and across the organisation, through clinical, strategic and operational representation.

Dr Henry said: “Within the HSE, I have established a Just Culture Working Group to ensure that we have a robust, proportionate and just approach to accountability following patient safety incidents in line with best international practice. It’s important that we provide a consistent and evidence-based strategic approach to the implementation of Just Culture where staff feel psychologically safe to speak up for safety and learn from patient safety incidents.”

The Just Culture Working Group includes HSE staff, clinical and patient representatives, and academic experts in the field of Just Culture and builds on work already underway: enhanced collaborations between service providers, service users and patient representatives, and education in communications, Human Factors and Systems Analysis.

Dr Orla Healy, National Clinical Director for National Quality and Patient Safety Directorate (NQPSD), HSE, said: “I’m delighted to see so many attending today’s event, which shows the support and significance of implementing a just culture by our staff and patient partners. There is good work happening across the health service in this area and today will see a more joined-up and collaborative approach affirming the organisations support of this approach.”

The conference heard from Mersey Care NHS Foundation Trust on their experience of implementing Just Culture, including the challenges, barriers and opportunities that supported implementation, as well as the successes and key actions for the implementation of a just culture. The absence of a Just Culture can contribute to a culture of blame, with staff experiencing shame and fear following an incident.

Dr Healy concluded: “We hope that attendees will leave here today with a clear sense of direction in this area, drive for its implementation locally, and a deeper understanding of how a just culture will support staff, deliver better care for patients and benefit our health service.”

Last updated on: 23 / 05 / 2023