Just culture

“Just culture” is rightly, a much-used phrase in patient safety and a major theme in the patient safety strategy for England and all the UK countries. However, there is no single definition of ‘just culture’ and most discussion of it is limited to the issue of being fair to healthcare staff. This is vitally important, which is why we advised on and endorsed the NHS Resolution Being Fair guidance and NHS Improvement’s Just Culture Guide.

However, AvMA and many of the stakeholders we have spoken to believe that we need a nationally agreed definition that places equal emphasis on being fair to patients and families, and which covers the whole system, from policy formulation to the delivery of healthcare and what happens when harm occurs.

AvMA have produced a vision of what just culture should look like. This has been developed in discussion with various stakeholders, and rather than being presented as a finished article it is intended to act as a catalyst for discussion leading to a commonly agrees definition, understanding and approach to just culture in healthcare. We would welcome your comments.

AvMA believes that the creation of a Patient Safety Commissioner as recommended by Baroness Cumberlege in her review of medicines and devices First Do No Harm could help foster the right culture at the top and policies which are more conducive to an inclusive just culture, if the role were expanded to include patient safety across the board. We are trying to use our influence to ensure that happens.