The much publicised Francis Report into the failure of Stafford hospital, highlights the significant gap between what the public expect of the caring professions and what some users actually experience, not just at Stafford Hospital but throughout the NHS system. It signals a real opportunity for every hospital trust board to change what is clearly unacceptable and create a new patient focused culture. So how can NHS leaders and communication professionals change the culture and put the patient at the heart of their services?  Effective communication is the key. Francis highlights the need to have a culture of “caring, commitment and compassion” starting at the top. He is right, but to work, it very quickly needs to become endemic across each Trust, ingrained in every employee. Trust leaders needs to create a coaching culture that develops and reinforces positive improvements in every individual at every level, empowering them to take responsibility and encouraging them to act to correct issues, challenging every fellow member of the team, as well as themselves, to continuously improve, sharing learning points and best practice. It needs total commitment and clear communications – resetting the expectations and approach of every team and every individual.  To grow the performance of each team member, you assess the issues, identify the performance gap and the reasons behind it, empower every individual to address the problem and monitor the improvement in performance of themselves and their team. The key is to ensure that every leader, at every level, clearly communicates their expectation of what success looks like and what is needed to achieve it. Successful leaders:

• • Constantly challenge themselves and their teams to look for better ways to deliver the outcomes they have identified.
• • Create a culture that says “Good is never good enough.” It becomes a personal quest of every member of the team to look for and suggest improvements.
• • Jointly takes responsibility for each other and if issues do occur, address them quickly, focusing the whole team on how they can be resolved and lessons learned to prevent them happening again.

To deliver a real change in culture, communicators must ensure that all the staff are engaged, so Trust managers need to:

• • Reassess the systems, processes and behaviours they use when dealing with patients and each other, focusing on effectiveness and delivering a good patient experience;
• • Challenge themselves and their team members to find ways to continually improve;
• • Ask the right questions in an open way and listen, far more than talk, taking on board what they hear rather than defending the status quo.

Effective leaders learn how to provide positive, constructive, feedback and use a coaching style of leadership to help team members continuously develop their skills, practices and behaviours. Each person needs to take accept responsibility and accountability for their own and other team members’ actions and behaviours, without being judgemental. Everyone should have the right to input ideas and observations, respecting each other and the patients, who are a key part of the team working to resolve the medical issue they have presented, not simply “the objects to be processed”. Such change won’t come from regulators, but will from informed, effective Trust leaders, supported by effective empowered communicators who together, can create a positive, self-improving culture, igniting the spark within each employee, sharing their vision of what is expected, and reinforcing it, again and again. Trusts need to take action now. If they need help, then they shouldn’t hesitate to ask for it.  MTM Skills Training is certainly willing to share our ideas and considerable experience in this area, to help any Trust create the sort of positive changes that are needed to make Francis’ recommendations become a reality. Warwick Partington (MCIPR, MIoD) is Managing Director of MTM Skills Training