Hot on the heels of last week’s headline grabbing story regarding the new website which, as part of its brief, will name and shame NHS Trusts which have been rated poor for honesty and openness, Health Secretary Jeremy Hunt has gone on record to state that he wants to expose doctors whose failure to spot cancer may delay sending patients for potentially life-saving scans.
Naming and shaming is undoubtedly an NHS Hot Topic at present and therefore likely to be the subject of medical interview questions. When asked a question on any topic, an effective answer conveys the correct factual information that is then used to convey a reasonable opinion.
But is naming and shaming only an issue for the top line of NHS leadership and management?
In his powerful lecture “Doctors make mistakes. Can we talk about that?” Dr Brian Goldman makes a very persuasive argument that the approach to errors is a piece of medical culture that has to change at all levels. He discusses the messages which are ingrained from the earliest stages of being a medical student: “Be perfect; never, ever make a mistake”. He describes his feelings of being alone, isolated and of shame when a mistake has been made. He highlights that there are two kinds of physicians: those who make mistakes and those who don’t, those who can handle sleep deprivation and those who can’t. He then goes on to describe what he calls the “redefined physician” who “is human, knows she’s human, accepts it … and she works in a culture of medicine that acknowledges that human beings run the system.”
Such an understanding, supportive, learning culture is quite different from both the naming and shaming world and the other unpalatable alternative where mistakes are hidden, denied and ignored.
Culture is something which has to be grown, nurtured and cultivated which depends upon deliberate acts of leadership and management. The Healthcare Leadership Model states very clearly that these acts are not only for those who have the title of leader or manager. Going back to Dr Brian Goldman, “it starts with one physician – and that’s me”.
Where do you stand on the naming and shaming approach to managing the NHS?
