Culture as culprit, culture as remedy
Over the last two decades, the policy and managerial rhetoric in the NHS around culture as either villain in manifest failings, or magic ingredient in service improvement, is based on a number of implicit assumptions which require a good deal of critical examination.
In a recent BMJ article Professor Russell Mannion, HSMC University of Birmingham and Huw Davies (St Andrews) argue that such simplistic diagnoses and policy prescriptions around culture lack depth and specificity. In addressing this concern they unpack what is meant by organisational culture in a health care context and explore, both conceptually and empirically, how notions of culture relate to quality, safety, and service improvement. They conclude by arguing that although a cultural perspective provides an insightful way of thinking and a practical set of tools to support wider quality improvement work, cultural reform in healthcare is no substitute for adequate resourcing.