Mind the Gap

A post “Francis Report” organisational development and culture health check


The publication of the Francis report creates a watershed moment in the NHS as a result of which the balance between efficiency/productivity and humanity will be re-defined.

Key findings from the Francis report:

  • Standards & methods of compliance: there was not sufficient clarity around standards on safety and patient care.

  • Openness, transparency and candour: In Mid Staffs, early warning systems were immature and ineffective.

  • Improved support for compassionate nursing: In Mid Staffs, the staff behaved in ways that were a total betrayal of what the NHS stands for. The NHS CB values kindness, thoughtfulness and compassion in NHS staff as much as their technical skills

  • Strong, patient-centred leadership: In Mid Staffs, the NHS failed to listen to patients

  • Accurate, useful and relevant information: Everything we know, we will share – so the public have better information about what is going on.

Post Francis – organisational needs

To assure both service users and staff members that the organisation is actively responding to the concerns raised in the report in a measured and considered manner.

To create the means by which the organisations leadership can be better connected to service delivery, quality and standards.

“Mind the Gap” – aims and intentions

To assess the degree to which we consistently deliver what we say we aim to deliver when it comes to patient care answering the question  – “is there a gap between our words and our actions?”

  • To what extent is the experience of our service users in keeping with our intentions?
  • To what extent does day to day working practice for our staff reflect and support our patient care aims?
  • To what extent is the organisational leadership in touch with patient care standards?

Are we as connected as we need to be?

“Mind the Gap” Patient Care connections diagram. Service users - How good was the experience? Has the service improved over time? Where and how can we improve where necessary? Staff - How good do we think we are? How good do we think we could be? Where and how can we improve where necessary? Partners - What are we like to work with? How good is the service we provide? Where and how could it be improved? Leadership - How good do we think we are? How good do we think our staff think we are? Where and how can we improve where necessary?
“Mind the Gap” Patient Care connections diagram (click to enlarge)

“Mind the gap” – research methods


  • Face to face structured interviews c. 1 hour
  • On-line survey


  • On-line survey
  • Focus groups

Service users

  • On site surveys (consumer market researchers)
  • On-line survey


  • On-line survey

“Results into Action” workshop

Objective – to create common agreement amongst key stakeholders about:

  • The current quality and perception of the quality of patient care
  • The cultural and behavioural attributes that foster higher standards of care
  • Prioritising areas for improvement
  • Improvement action planning
  • Communication planning

“Mind the Gap” - outcomes

The primary objective of this intervention is to quickly and objectively assess the status of attitudes and perceptions towards patient care and identify good practice that can be used to influence areas where improvement is needed.

The end result allows organisations to take action, to recognise and reinforce good practice and make improvements in areas of weakness.

“Mind the Gap” – project plan and costs

“Mind the Gap” – project plan and costs diagram. Leadership (structured interviews, Online survey) -> Staff (Online survey, Focus groups) -> Service users (On site face to face survey, Online survey) -> Partners (Online survey) -> Results into Action workshop (Asses survey results, Action planning). 4-6 weeks, £20,000 - £25,000
“Mind the Gap” – project plan and costs diagram (click to enlarge)

Potential next steps

Potential next steps. Vision, mission, values & behaviours - In light of the outcomes of the “Mind the Gap” exercise to what extent are our vision, mission organisational values and behaviours appropriate? Culture change – “I can and I will©#8221; - A culture change programme designed to bring about a change in management style and ethos that empowers front line staff to spontaneously take appropriate action in patient care. Embedding culture change - Developing tools, materials and techniques to promote the vision mission, values  and to recognise and inspire the organisational behaviours that lead to higher standards of patient care.
Potential next steps diagram (click to enlarge)

For more information about the the “Mind the Gap” programme contact Ann Hepworth, Healthskills Director on 07867 538165 or [email protected]

Healthskills quotes and tesimonials


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