Building Trust In NHS Organisations

The NHS collectively is a huge organisation.  Even more locally they are major employers, with significant income and expenditure.  If teams of people are to perform to their potential, there is a need for high levels of trust.


We are all probably familiar with stories of clinical staff not trusting those in management or non clinical roles.  At the same time a lack of trust can often arise between clinical teams and even within clinical staff in the same professions.


The absence of trust can often result in behaviours which might well seem in the interests of a particular group but are potentially detrimental to the wider organisation and service users.


So what can NHS organisations do to build trust across the organisation and even across wider health economies?


Be Open To Different Perspectives


Whether we like it or not, the reality is that different groups will have different deliverables or results to achieve.  How people will look at issues and consider decisions will depend on their perspectives.  Acknowledge this and accept that these different perspectives are actually valuable.


Learn To Listen


Most person specifications for roles in most organisations, including the NHS talk about the need for communication skills.  For me, communication skills need to be broken down to their component parts, written, verbal and listening.


I am pretty sure the majority do a great job in the areas of written and verbal communication.  On the other hand fewer do a great job when it comes to listening.


Remember we have two ears and one mouth.  Learn to use them in correct proportion.


Be Transparent About How Decisions Are Reached


No one expects to get the outcome they want 100% of the time.  However, people want to know how decisions are reached.  Being transparent on your decision making process and then following this helps everyone to better understand the why behind decisions.


Make Sure Words and Actions Are Congruent


It is no good talking about the importance of quality, patient experience and patient safety and then acting in a way that is not consistent with what you say.


Always Think Patient and User


When people are under pressure, it is easy to lose sight of the patient or service users or relatives.  We can easily take what is the norm for us as being the norm for patients or relatives.


Take A&E for example.  At the moment there are reports of departments bursting at the seams, which is often the case.  Yet from my own experiences it is often a simple lack of communication that causes concern.  Sometimes it just takes someone to step back and take a few minutes to explain to patients and relatives what is happening.


The Reality:  Building and maintaining trust in NHS organisations is never task and finish but an ongoing process that requires effort from every employee.


I would love to hear your views of good practice that has helped build trust and invite you to leave a comment.


Goals and Achievements help healthcare organisations deliver great service and performance through great leadership and team working.  You can sign up for our free report 10 Management Mistakes That Impact On Performance In The NHS here

  • The fact that this question is broad ranging in itself and in the responses it prompts highlights (IMHO) the need for a generic conceptual framework that can incorporate the aspects and contexts you raise above. A framework that is neutral in terms of disciplines, accessible to the majority of the public. A resource that is situated and multicontextual – useful to frame critical reflection on the many perspectives that pertain. Patients are also employees, unemployed, citizens, carers, experts, students and much more (taking in equality and diversity for example). In reflection we need to turn-all-the-stones and consider the social, technical (sciences), political and the intra- interpersonal (the spiritual too).

    Has anyone done any research on the size of health organisations over the past twenty years and the communications within them? A difficult thing to measure, but in terms of trust as organisations become larger are they more impersonal?

    Building trust between staff could be furthered through interprofessional education, but how embedded is this? ‘Building’ suggests an ongoing project, which by its nature needs to be sustained. If trust is achieved then perhaps transformation could be self-sustaining – ‘built on trust’ – shared belief!

    There are posts about the framework mentioned above at:

    Welcome to the QUAD

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