DHBs continue to fall short on workplace culture

DHBs continue to fall short on workplace culture to encourage clinical engagement

“District health boards are continuing to fall woefully short when it comes to providing a workplace culture that encourages clinical leadership in health decision-making,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

“A survey of our members highlights yet again the fact that the people running New Zealand’s public hospitals need to be doing a lot more to actively involve senior doctors and dentists in decisions that will, ultimately, affect patient care. We surveyed members on clinical engagement 18 months ago, and it appears as if nothing much has changed.”

In the 2015 survey, ASMS asked its DHB-employed members a number of questions related to distributive clinical leadership. The most recent findings are still being analysed but already indicate that DHBs have made little progress in terms of their commitment to clinical leadership:http://www.asms.org.nz/wp-content/uploads/2015/07/DHBs-need-to-improve-commitment-to-distributive-clinical-leadership_163958.2.pdf

“That also seems to be the case when it comes to our members’ responses to another survey question about the culture within DHBs,” says Mr Powell. “A few DHBs are doing all right when it comes to clinical engagement (although not as well as we’d like), but many of them are doing poorly.”

For the 2015 survey, 1182 of our DHB employed members responded; a response rate of 31.6%. Overall, this sample size is adequate at the 95% confidence level with +/- 2.5% margin of error. Disaggregated to individual DHBs, however, the response rates vary considerably and as a consequence, some DHB responses have limited statistical validity. Nevertheless, as always, the results are illuminating and align with members’ own reported experiences.

Some initial observations include:

• Compared with the 2013 survey, the average responses are slightly more negative and no more positive in 2015 (54 to 59% answering ‘no and 28 to 27% answering ‘yes’), suggesting little has improved in terms of DHB culture towards distributive clinical leadership.

• Members in the Southern and Hutt Valley DHBs responded the most negatively to this question. Hawke’s Bay and Canterbury’s responses were the most positive but still less than 60% of all respondents answered ‘yes’.

• Lakes DHB’s responses suggest a declining performance in this regard. In the 2013 survey, they had 63% answering yes with only 14% in 2015. This drop of 35% was statistically significant (p=0.003).

“Health bosses have an obligation to create a culture within hospitals that actively fosters clinical leadership and draws on the expertise that is available,” says Ian Powell.

“Public health professionals, including doctors, are highly motivated and wish to ensure the best possible treatment and care is available for their patients. It’s up to their bosses to create a culture that values their expertise. Anything else results in a negative, isolated working environment which will undermine the ability of hospital specialists to fully contribute.”

ENDS

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