In Mind: Chief Executive Joe Rafferty on the insight of Professor Sidney Dekker, a world renowned expert in 'Just Culture.'

A Just and Learning Culture experience

I thought I’d focus the majority of this week’s blog on our commitment to adopt a Just and Learning Culture within our organisation. I know I’ve written about this in the past, but that was before we experienced a masterclass presentation, demonstration and analysis into how we are doing this week from Professor Sidney Dekker, a world renowned expert in the field.

Professor Dekker provided many valuable insights into how Mersey Care is progressing as an organisation and, importantly shared his experience as the world’s foremost expert in ‘Just Culture.’ For everyone attending the event at Aintree earlier this week, including our Just Culture Ambassadors from across the Trust, I’m sure they emerged from the session with a greater understanding of what we need to do to make our trust a truly learning organisation.



"A just culture is about trust, learning and accountability...with restoration of compassion at every level," was just one of the many thoughts he shared with us, which is something we are trying to introduce into Mersey Care’s wider practice. Is anything ever such an emergency that you can’t stop and think about how am I going to react to this? There’s an awful lot of wisdom in that because there’s more time than we think. Less haste and more speed is something that sometimes we really need to think about but which is something that is no mean feat to achieve when services are busy.

Professor Dekker also shared the thought that culture can’t be bought or imported, it can’t be brought in through consultancy and we can’t declare it’s happened and assume that it will. The development of a just and learning culture is about doing the hard yards and growing and learning together as an organisation. We have started that journey by introducing big changes into the disciplinary process; after all, it is only when you remove the fear of sanction that people can speak truly openly. Through this process we have seen immediate improvements in reduction and restraint, violence against staff and staff sickness rates.

It’s been tremendous to have a world leading expert like the Professor come and critique what we’re doing and give us the advantage of his immense wisdom and experience. One of the great things to report back is that he thinks we’re on the cutting edge of healthcare in trying to put a just culture in place. That’s really important to understand the innovative nature of what we’re doing, but also we need to be in this together because it’s only by being in this together we’re going to make it work.

Equally important is to remember that Just Culture is the lubricant that oils the cogs which turn the wheels and allows change to take place. It’s really important to appreciate that Just Culture isn’t an end in itself. It’s an important guide that works alongside all the other tools and techniques we use to deliver us to a learning culture.


I think a learning culture won’t be developed overnight. It’s very easy to think you’re in a learning culture just because you’re exchanging information. In reality you’re only truly in a learning culture when we learn from every experience to develop our practices in the Trust. That will be a requirement of every single person within the organisation no matter who you are or where you work and I really hope you’re as excited as I am about the journey ahead.

Nice to hear

We’ve all rightly celebrated our ‘Good’ rating in our CQC report but it is always nice to also be given recognition from outside sources. I received a lovely email this week from Fiona Taylor, Chief Officer at South Sefton and Southport and Formby CCGs, offering her “thanks and congratulation” for the outcome of our recent CQC report and acknowledged all the “hard work that is undertaken.”

This external recognition from one of our major commissioners was great to receive and shows that the hard work that we do here is really appreciated by others outside the Trust. So thanks Fiona, you really made my day.