A recent report into 14 Hospital Trusts in the UK with very poor performance came to the conclusion that nobody was paying any attention to the elephant in the room. The Trusts were "not really listening to contradictory evidence". There was no attempt to seek the views of patients, and staff felt uncomfortable about raising their own concerns with management.
Using principles taken from "Courage to Change" a new manager has recently been able to transform the key relationships with her staff. Something had to change - and it needed to start with Kate!