Health chief tells board it must lead culture change

Interim chief executive Tim Davison said NHS Lothian had to acknowledge it had a “significant problem”, and told board members that their own behaviour would be the most important factor in solving it.

Mr Davison was appointed at the end of April to replace James Barbour, the chief executive who retired days before an investigation at the health board uncovered an unhealthy, overbearing management culture there.

The probe was ordered after NHS Lothian staff were found to have wrongly suspended around 7000 patients from waiting lists in a bid to hit government targets.

Consultants David J Bowles & Associates and PricewaterhouseCoopers said staff had been under huge pressure to hit the targets without support from their managers, and were discouraged from delivering bad news.

Speaking at the NHS Board meeting after his appointment, Mr Davison said: “Whatever people might feel about the circumstances that led to this report, my strong view is it’s very important that we work out how we move on from here because we’ve got some very important things to put right.

“People who have been here for a long time might want to reflect on the circumstances that led to this.”

He said that, even if the management culture was reformed, the financial pressures on the health board which contributed to the situation would not change.

“There’s no doubt NHS Lothian is under very great pressure,” he said. “Like all public services, we’re under considerable financial pressure. The growth in demand is outstripping the growth in resources and that’s not going to go away.

“I think we need to acknowledge that we’ve got a significant problem and we’ve got to fix it.”

He said there would be two parts of his approach to solving the problem, adding: “The first [strand] is the recommendations in this report. We’ve got some serious organisational development to do.

“Even more important is the way in which we behave in tackling those pressures. It’s how we work together as a single team in Lothian that will actually be the most influential.”

The meeting heard that a steering committee is being set up to lead the process of change, and is likely to stay in place for at least a year.

Lothian branch chairman for Unison, Tom Waterson, said that his initial meetings with Mr Davison on management culture had been positive.

He said: “He certainly seems like someone we can work with.

“Obviously, the culture can’t be changed overnight but we certainly are confident that, with Tim Davison and proper partnership support, we can tackle the culture that’s previously existed in NHS Lothian.”