“‘Diva’ doctors threaten patient care.”¹
We have reported on the culture in the NHS previously here→ – and elsewhere.
New research commissioned by no less that the General Medical Council has identified five problematic subcultures amongst doctors in leadership roles:¹
“Diva subcultures – powerful and successful professionals are not held to account for inappropriate behaviour. Left unchecked, divas become viewed as untouchable, and colleagues accommodate them and work around them.”
It was easy to find an image of a female diva but it is likely that are outnumbered easily by male divas. The other four subcultures are harder to illustrate!
“Factional subcultures – disagreement becomes endemic, and the team starts to organise itself around conflict. Those in dispute look for support and loyalty from colleagues, and staff may seek to avoid working with those on the ‘other side’.”
“Patronage subcultures – arise around influential leaders who have social capital in the form of specialist knowledge, professional connections, high status, respect and access to resources.”
“Embattled subcultures – where resource has been inadequate, and unequal to demand, practitioners eventually become overwhelmed. They feel besieged by the unmet need they see in patients, and may show signs of chronic stress such as short temper, anxiety and burnout.
Insular subcultures – some units become isolated from the cultural mainstream of a larger organisation, resulting in professional practice or standards of care that deviate from what is expected. The isolation can be geographical or psychological.”
And of course these subcultures aren’t mutually exclusive. They may often co-exist alongside one another in the same organisation.¹
We believe that some of these features could be applied equally to many in NHS leadership roles, not just doctors.
I struggle to categorise Southern Health NHS Foundation Trust and may be able to identify features of all five subcultures. For now, from personal experience, we know that there are divas, who are not held to account for inappropriate behaviour and already consider themselves untouchable.
Would anyone like to suggest the subcultures that exist at Southern Health! If so please use the reply facility here→
² General Medical Council.