Developing a just culture in the NHS

Over the years there have been several buzzwords and phrases in the NHS—patient advocacy, accountability, clinical governance, to name but a few. These terms focused attention on certain issues with many study days and articles. They are general, open-ended terms and various meanings can be ascribed to them. In a sense, they can mean whatever we want them to mean. They instil debate, which is a healthy exercise.

The key point to remember is that it is the ideas behind the label that matter, not necessarily the label itself.

These terms are still with us but there are other, perhaps more contemporary, concepts that now vie for our attention. One of these terms is ‘just culture’. This term is frequently bandied around the NHS and people make regular pleas for it. The patient safety and justice charity Action Against Medical Accidents (AvMA) points out:

‘There is no single definition of “just culture” and most discussion of it is limited to the issue of being fair to healthcare staff.’