NHS culture change is difficult, not impossible—but essential, says health ombudsman

Early on in his career as a civil servant, Rob Behrens, now the parliamentary and health service ombudsman, was sent by the UK government to South Africa, to work on the transformation from apartheid to democracy. “People in Britain used to say what they had to do was hard. I would come back from South Africa and say, ‘You don’t know you’re born.’”

It’s an anecdote he uses when talking about culture change in the NHS. Although change might be difficult, it is not impossible, and it is something that needs to happen, says Behrens, whose role is to adjudicate independently on complaints that have not been resolved by the NHS in England and UK government departments.

“There is huge professionalism and commitment throughout the NHS. It’s been through the mill in a way that no other institution has—because of covid, strikes, and shortages of staff,” he says. “But unless we call everyone together to have a conversation about the emerging problems around the suboptimal culture in the NHS, then we will miss a big opportunity.”

Behrens was appointed to his current role in 2017, having previously worked investigating allegations of public service failure in the legal and higher education sectors. During his six years as parliamentary and health service ombudsman, a non-governmental role, he has seen many investigations and reviews into poor …