No blame policy is not no blame culture

Mathew’s headline talks of the “limits of a no blame culture” but the text mentions “worrying about breaching a ‘no blame’ policy,” indicating the absence of a no blame culture in the NHS.1 Leary2 and Oliver3 go on to provide ample evidence of a blaming culture and its harmful effects on good care.Discussions of the cases of Letby, East Kent Maternity Services, and others overlook the extraordinary difficulty that individuals experience in acknowledging and managing the conflict between avoiding embarrassment, humiliation, or distress for themselves or their colleagues and honestly and openly examining behaviour for which they might be responsible (and blamed). The more blame a person expects, the greater this conflict becomes. As such, aspiring to a true no blame culture is essential to facilitate early action to stop similar problems in future.Veale and colleagues outline the importance of emotional safety in healthcare.4 The absence of fear of blame…
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