Maternity services are a key area of focus for the NHS. Like other sectors, their services are in a period of transition following the aspiration defined within the Five Year Forward View (2014) and NHS Long Term Plan (2019) where we look to have women-centred care, choice, continuity of carer, safety, reduced inequality and a ‘habit’ of continuous improvement in the experiences of service users. A high-performance culture is one that delivers on these aspirations. The report states that there is “significant regional variation in extended perinatal mortality. Of the term babies who died in 2016, different care might have led to a different outcome for 71%.” To make the Long Term Plan a reality, the NHS will need to ensure a supportive culture for staff. By better supporting and developing staff, NHS employers can make an immediate difference to retaining the skills, expertise and care their patients need.
There is growing clarity on what needs to change to build the desired future state for maternity care: powerful and integrated relationships, capable, compassionate staff committed to the provision of safe care for all, clear, measurable goals and objectives, informed decision making and efficient use of resources. It is also acknowledged by many people that culture plays a powerful role in ensuring the high performance that brings the transformation required for the Long Term Plan. However, the Care Quality Commission (CQC) reports would suggest it remains a term that escapes consensual definition and is often considered difficult to manage in a measured way.
Our maternity team can support you to utilise the Denison diagnostics to aid understanding of the barriers and facilitators to the successful implementation of evidence-based maternity care. The Denison cultural model is an approach rooted in years of research exploring and examining the impact that the culture of an organisation has on the performance of the organisation. The model was built on research on the key cultural factors that influence delivery and has been applied in many studies to show that organisations with the characteristics defined by the model were strong performers with respect to a wide range of performance measures such as service user satisfaction, innovation and quality. The model has the most published research on the performance impact of culture and underscores the assumption that the culture of an organisation is a key driver of performance and safety.
We can combine this approach with storytelling which supports organisations to unite behind a common purpose, where stakeholders understand and believe in the journey of the organisation and the personal role they can each play in its success. Having written and told the story, to provide an understanding of people’s deeply held beliefs and assumptions for what it means to work in your organisation. The Denison culture diagnostic will help define the synergies and discrepancies of the current state. It will enable your strategy to be implemented by managing your culture.
We offer you an approach that will facilitate engagement and understanding, and a method of monitoring progress and identifying the next steps. Our approach is an inclusive one which enables ‘top down’ to meet ‘bottom up’.