Cultural audits as tools for enabling processes of change in the NHS

Abstract

The organisations that make up the NHS are subject to frequent change, either as a result of top-down restructuring, or of internal reorganisation. There is considerable evidence that one key to the success of such change lies in understanding the culture of the organisation that is undergoing change, with various authors suggesting that cultural audits be undertaken as a means of achieving this. Cultural audits as described in current literature can be complex, time-consuming and resource-intensive, which may be one reason that, in our experience, they are not often conducted. This paper describes a method of assessing the culture of an organisation rooted in ethnographic principles from Social Anthropology which is relatively simple, can be carried out in a few weeks, and requires a manageable level of resource. The method has been used to good effect in a number of NHS organisations. An example of its successful application is presented. The authors hope that this method might become widely adopted, leading to a higher success rate for change programmes in the NHS.