NIHR SafetyNet Organisational Culture working group. What is Organisational Culture?

I went to the NIHR SafetyNet Organisational Culture working group meeting in Birmingham on a cold day in January. I wanted to learn what “organisational culture” means and how it links to patient safety.

So, what is organisational culture?
After listening to researchers from different PSRCs, I learned that organisational culture is basically how people at work get along. It includes the relationships between colleagues, managers, departments, services and different job roles.

How does this affect patient safety?
The way people treat each other at work can directly affect the care patients receive. If communication and relationships between teams are poor, things can go wrong.
For example:

1. A patient might be sent home from hospital, but no one tells their family or carers, so no one is there to meet them.
3. A family may still be waiting for a call to say they can collect their loved one, only to find out the patient has already been taken home by hospital transport.

But when communication and teamwork are good, patients get much better care.
For example:

1. Maternity staff might tell new mothers about breastfeeding support available in their community.
3. If an older person is having surgery, hospital staff may work with community care teams and family members to plan what help the patient will need at home.

The biggest thing I learned

If staff are unhappy, feel unappreciated, experience bullied, or feel insecure in their jobs, this can lead to poor communication and bad relationships at work. This can then cause poor-quality services, lower standards of care, and higher risks to patient safety.

But if staff feel happy, valued, and supported, they are more likely to work well together. Good relationships between teams mean better services, higher standards of care, and safer experiences for patients.

Dr Matthew Cooper, NIHR Newcastle PSRC Safer Integrated Health and Social Care Environments, Research Associate

Broadening My Understanding of Organisational Culture

Attending the organisational culture working group helped me to broaden my understanding of what organisational culture truly represents. Initially, I viewed workplace culture mainly in terms of supporting staff wellbeing and keeping people happy and healthy at work. Through the discussions, I realised how strongly organisational culture also influences patient safety and the consistent delivery of high-quality care.

Exploring the Ambition of the 10‑Year Plan

The working group explored the ambition of the 10-year plan, which is expected to drive change both during the next 10 years and for the future beyond. This however highlights some key risks:

• That pressure to deliver quickly could lead to rushed decisions,
• Missed input from some disciplines (implementation science for example), or
• Action being taken without full consideration of the plausible impacts (for example removing resources from one service to fund a new idea).

A strong emphasis was placed on transparency of quality of care, including empowering patients through greater voice, choice and access to information. This was balanced alongside clearer accountability and stronger incentives for high-quality care. I was particularly struck by the challenge of double running costs, where services must continue to operate while resources are reallocated, and the importance of deliberately creating time for safety within this context.

Reaffirming the Core Purpose of Organisational Culture

Overall, the working group reinforced that the core goal of organisational culture is to support patients, underpinned by robust checks and balances, compassionate leadership, and a shared commitment to quality and safety at every level of the system. As a team at the NIHR Newcastle PSRC, this is something we are all hoping to reflect on and take forward in our research.

Learn more about the NIHR 10 year plan.