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“keeping our reforms patient focussed became a driving force to change the culture, it broke down the barriers”

Helen Wilding, Torbay Care Trust

The presence of a positive and supportive organisational culture often goes hand in hand with high quality care and an enthusiastic workforce. When organisations and teams need to come together, understanding the similarities and differences between the organisational cultures, values and priorities can be a considerable challenge. This is often underestimated, but is essential to achieve joined-up care.

Throughout any transition teams need to explicitly seek to understand the cultures and values of each of the organisations (or teams or departments) who need to work closely together in order to achieve joined-up care. There needs to be an openness and honesty to the discussions so that any real issues and challenges can be identified, understood and worked through. Building mutual trust is essential if care is to be successfully joined-up. We know of examples where clinicians have not trusted the judgement of other clinicians and have repeated a clinical assessment. This is not only unnecessary but it can be worrying for the patient and is a waste of time and money. We are also aware of examples  here patient records are transposed from one form to another because of clinicians preferences, this type of practice is again wasteful but can also present a safety risk. Building trust is an important component in any process of joining-up care and failing to address it will mean that attempts to join-up care will not be successful. Recognising that people will feel uncomfortable and unsure during periods of change and spending time working with these feelings is beneficial.

Key questions

Key questions you should ask to make sure you are thinking about organisational cultures:

  • What are we doing to articulate the vision and values that we expect in the new joined-up services?
  • Are we telling a compelling story about how the new services will improve the patient experience?
  • Do we understand cultural behavioural patterns within our organisations and the implications that these might have on successful implementation of joined-up care?
  • What help do teams need to change unhelpful patterns of behaviour, what can we do to help them to work together effectively?
  • What can we do to build trust between individuals, teams and organisations?

Case study

See how Torbay Care Trust are developing Seamless care for patients with multiple co morbidities improving the interface between  primary and secondary care, developing new models of working. They identify that changing the cultures and the underlying attitudes beliefs and subsequent behaviours is a big challenge. They are listening to individuals, bringing the groups together, to consider patient experience and to look at the qualitative data which is starting to break down the barriers, changing behaviours and allowing services to be delivered in new ways. Read all the Joined-up care case studies, which can be accessed to the right of this page.

Patient experience and engagement resources Resources to support you with patient engagement and experience

Measuring the improvement guide

A straightforward process to enable you to measure the improvements you are making to your service

Download the 'Measuring the Improvement guide'

Joined-up care literature review

Download the literature review


Read Joined-up care case studies relating to:

  • Patient centred
  • Leadership
  • Culture
  • Workforce
  • Making it Happen
Visit the case studies page for downloads and films

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