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Blog Mary Agnew


Rebuilding trust

Posted by: , Posted on: - Categories: Blog, Francis, NHS, Uncategorised

Guest blog by Sue Covill, Director of Employment Services at NHS Employers

Do you remember years ago when as a rite of passage new student nurses used to be sent to the orthopaedic ward for a "long wait"?  Many of them expected to be given a "long weight" to take back to their ward - but no, for many it took quite a while for the penny to drop. I recalled that student dilemma when in discussion with colleagues about the implementation of the Francis report. We were discussing why some trusts have been making great progress in looking at their values, engaging with patients and carers over what's important to them and ensuring that all their systems and processes are underpinned by these priorities. Yet in other areas progress has been slower, and we wondered what colleagues were waiting for. Have we become so used to the top down approach that we now expect to be told in detail how to deal with the lessons of Francis? Or are we concerned that we'll get it wrong or be at odds with national approaches?

Rebuilding public trust in our services is one of the most important challenges the NHS and we personally will ever face. It's too important to wait or find reasons for delay. There's no better place to start than by having discussions locally with patients, staff and other stakeholders about what's important. Colleagues at trusts in Nottingham, Salford,  Oxford, York and many others have already done a huge amount to understand what makes a difference to patients, and to develop strategies which are based on key values. In a number of trusts, workforce processes and systems now reflect these values from recruitment, induction and appraisal, to development, recognition and performance management.

Recent research by Professor Veronica Hope Hailey of Bath University identified some key components in maintaining and developing trust following organisational challenges and crises. Leadership as service was a particular issue - serving staff as well as stakeholders throughout any rebuilding period. Creating a trusting culture - leaders must be trusting if they expect to be trusted themselves and model the behaviours they wish to see.   Re-engaging middle and first line managers was also critical in maintaining or re-establishing trust as was "killing spin" – ensuring an open and honest approach to communications.

Professor Hope Hailey shares an old Dutch proverb "trust arrives on foot and leaves on horseback" - slow to build and quick to lose. So all the more reason not to delay in beginning to rebuild trust in our services and amongst ourselves.


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