Culture of ‘Denial’ Is Admitted by NHS Chief Sir David Nicholson

26 June 2013

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Culture of ‘Denial’ Is Admitted by NHS Chief Sir David Nicholson

In the wake of the Mid Staffs and Care Quality Commission scandals, Sir David Nicholson said efforts were underway to change. However, he told a committee of MPs that some NHS managers were struggling to adapt. He also said when he was head of the body overseeing Mid Staffs; he regretted not listening to patients.

During Mid Staffs scandal, in which high death rates and patient mistreatment were ignored, Sir David has faced a high profile campaign for him to quit over his involvement in the scandal.

Sir David told the MPs: "I do think there a real issue about defensiveness and a lack of transparency in the way that we work." Referring to his own time as a complaints manager in an NHS trust, he said: "There is a very strong medical legal litigation culture in organisations and at that time, I know, the answer to any complaint was to deny - because of the potential litigation responsibilities for that.

He said "reputation management" was also more of a concern that it should be when failures came to light, which he said was part of the problem at Mid Staffs. "There is quite a lot of pressure on you as an individual, particularly from your staff, to represent and support your organisation publicly. So they are quite powerful things to combat. My argument is they absolutely have to be combated."

He also stated "The leadership of the NHS - not everywhere - is having difficulty coming to terms with that and is slightly behind it." He added, NHS managers had been more concerned with meeting targets and pleasing their bosses, such as him, than responding to the needs of patients.

Sir David was in charge of the regional health authority responsible for Mid Staffordshire for a short period while patients were being mistreated. He said he "felt apologetic" for that but said the data on mortality rates "did not cross my desk" - a situation he said would not happen to managers in the future.

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