Mersey Care NHS Foundation Trust is leading a culture change in supporting colleagues when things don’t go as expected. The trust’s work has seen material differences for staff and how we care and this is being shared nationally working alongside academics and NHS leaders. Training programmes and resources are available, aimed at HR professionals and the wider public, and in 2020, a new free online course is being made available jointly with the Zero Suicide Alliance.

Mersey Care’s internal research found barriers to transparency included fear, blame and shame. Staff and staff side colleagues started to ask, quite rightfully, about a zero blame culture. That in itself was an indication that the trust had made a change in thinking as it is only by promoting openness and transparency that we will accelerate our rate of improvement.

Lead by the Board, the trust has learnt from established academic works, in particular by Professor Sidney Dekker, author of bestselling book ‘Just Culture’. We’ve looked at industries like airlines, nuclear technology, oil and exploration and some healthcare in the US, all of which go about their daily business knowing there is always an element of risk. There is a very poignant example of how difficult this move can be captured in the true story of “Sully”, made into a film starring Tom Hanks. It focuses on the pilot Captain Chesley Sullenberger, who famously made an emergency landing on the Hudson River in New York. His actions saved all the 155 passengers and crew. Despite being a national hero, he was later investigated by airline authorities.

Mersey Care’s work to embrace a Just and Learning Culture has centred on the desire to create an environment where staff feel supported and empowered to learn when things do not go as expected, rather than feeling blamed. This is a culture that instinctively asks in the case of an adverse event: “what was responsible, not who is responsible”. It is not fingerpointing and not blame-seeking. But it is not the same as an uncritically tolerant culture where anything goes – that would be as inexcusable as a blame culture.

We tell the story of what happened in one NHS trust, Mersey Care. We look at how being a rules based organisation meant there was a lack of awareness of the psychological harm of some HR processes.

In the second module we acknowledge that mistakes can and will happen.

In the third module we hear that a Just and Learning Culture must have the full commitment of the Board of Directors, and senior leaders and influencers answer your questions.

Respect and Civility has never been more important; being polite, courteous and respectful, and treating everyone with dignity and respect and according to their individual needs should be the standard but with the internal and external pressures sometimes this can be lost.

The training package highlights the importance of behaviors to equip staff with the necessary confidence and tools to speak up if they witness something they think is not right #IWillSpeakUp.  The training gives examples of best practices, which will hopefully reinforce areas staff are already doing well in.