Ramsay Health Care UK is one of the leading providers of independent hospital services in England, with an award-winning network of private hospitals and over 30 facilities, stretching from Cornwall to Newcastle. It is also part of the global Ramsay Health Care group, an organisation with more than 77,000 employees across 11 countries.
Delivering safe care for patients is a priority for the Ramsay group and promoting a strong speaking up for safety and professional accountability culture remains an important part of the group’s continuous improvement agenda.
As the UK’s largest independent provider of care to NHS funded patients, Ramsay Health Care UK provides a wide range of specialised and efficient clinical specialties: from orthopaedics and general surgery to cardiac surgery and eye surgery. It also has an unrivalled reputation for being at the forefront when it comes to delivering the safest and most reliable patient care.
In response to the professional accountability challenges facing healthcare organisations, Ramsay developed ‘The Ramsay Way’: a set of principles which define its workplace culture and empower staff to speak up about patient safety. This internal mantra focuses on addressing staff and consultant behaviours that go against the group’s core values, to reduce overall patient risk. The new professional accountability framework needed to reflect this mindset, engage staff at all levels and work seamlessly across all 37 facilities.
Ramsay Health Care UK became the first UK independent hospital group to implement an evidence-based, organisation-wide professional accountability framework.
To help the UK team address the behaviours that undermine a culture of safety and drive widespread cultural change, Cognitive Institute recommended the Speaking Up for SafetyTM and the Promoting Professional Accountability programme.
Together, these programmes deliver a common language, improve internal communication and empower members of staff to prioritise patient safety.
Our approach also contextualises unsafe behaviours and provides a structure for defining critical safety and professionalism standards, so unprofessional actions can be quickly identified, measured and addressed.
To encourage success, Ramsay ensured full commitment from the Executive, Board and Medical Advisory Committee, as well as local working parties to develop a ‘no blink’ approach. The programmes were written into operating policy, resulting in their full adoption from board to ward. This provided staff with confidence knowing they had full, organisation-wide support to speak up.
It’s about giving staff the psychological safety so they are empowered to speak up and support colleagues by being a critical friend.
1. Speaking Up for Safety is delivered as a licensed train-the-trainer model, which enables the Ramsay team to achieve culture change from within, normalise two-way communication and prevent unintended patient harm. From senior clinicians to junior nurses, staff are encouraged to develop the skills and insight they need to respectfully raise issues about patient safety.
2. The Promoting Professional Accountability programme enables Ramsay Health Care UK to identify, engage and hold accountable staff who repeatedly demonstrate unprofessional behaviour. Built on the work of Vanderbilt University Medical Centre, the programme equips staff to identify and address behaviours that go against the principles of ‘The Ramsay Way’.
Over 6,000 Ramsay Health Care UK staff and visiting clinicians – 90% of all staff across Ramsay’s 37 facilities – have been trained in the Safety C.O.D.E.TM a common language on how to respectfully speak up, and the programme has reached 85% of staff in a 12-month period.
Anecdotal feedback has confirmed favourable clinical outcomes post-implementation. Ramsay Health Care UK believes the programme has helped address behaviours undermining safety.
Open Doctor Forums have been successful in helping to answer questions and encourage support, alongside open and transparent two-way communication with all key stakeholders.
The approach has also received industry-wide recognition. In 2021 Ramsay Health Care UK won a LaingBuisson award in the Health Outcomes category.
It’s become common language… people are using a prescribed code to say ‘I have your back and I’m supporting you and stopping us from making a mistake.”
