Vegan fruit cake

I haven’t baked this recipe for a long time as I’m no longer vegan, but it satisfied my passion for fruit cake for many years. It’s a rich, dark fruit cake and as long as you choose your marg and stout carefully it’s vegan.


  • 4oz marg
  • 1lb whole wheat flour
  • 2tsp mixed spice
  • 8oz malt extract
  • 2lb mixed dried fruit
  • rind of ½ lemon
  • 4tbs (at least) of stout
  • ½pt + 4tbs sugar free soya milk
  • 1 tsp bicarbonate of soda


Sieve the flour and mixed spice together. Blend the bicarbonate of soda with the 4tbs of soya milk. Mix all the ingredients and beat in a bowl. Poor into a suitable cake tin and bake at gas mark 3, 160°C or 320°F for 2-2½ hours.

After Grenfell, local authorities must break the link between fire and inequality

This is an article I wrote for The Conversation. You can read the original article here.

The tragedy at Grenfell Tower has brought the inequalities that exist in British society into sharp relief. The number of dead or missing and presumed dead has risen to 79 people in one of the Britain’s wealthiest areas, due to what London Mayor Sadiq Khan called a “preventable accident” caused by years of “mistakes and neglect” by government officials. Meanwhile, there have been accusations that the local council and building management organisation failed to listen to residents’ warnings about the risk of fire.

My ongoing research indicates that these points may all be linked. It’s a well-established fact that fire has always affected poorer communities more. To prevent fires, there must be effective engagement between communities and public services. But my findings suggest that the way these services operate does little to encourage disadvantaged and marginalised communities to work with them.

Searching for answers

In my own analysis of house fires in the West Midlands, I found striking inequalities in the way that fires are distributed. Areas with high rates of fire also tended to be areas where residents’ income was lower, unemployment more widespread, or a higher proportion of the residents came from black and minority ethnic groups. One earlier study found that children whose parents were long-term unemployed were a staggering 26 times more likely to die of fire related injuries than children whose parents were in higher managerial and professional occupations.

Surprisingly, though, there is little solid evidence explaining why this is so. It is easy to think of some possible reasons: poor quality housing; the inability to afford modern, safer electrical equipment; higher rates of smoking (smoking is a major cause of fire deaths). But the truth is that we just don’t know. It may be, though, that the communities affected by high rates of fire have some ideas. This is one reason why it’s crucial that those charged with improving fire safety learn to listen.

Deep fried plantain

Deep fried plantain – delicious, but risky.. Fimb/Flickr, CC BY

I spent time talking to people in a diverse, disadvantaged part of the West Midlands. Among those I spoke to was Peter, a Tanzanian man. I had already established that areas with high African populations tended to have high rates of fire. Peter had no doubt as to why this was. His community, he told me, are not used to cooking on gas and do a lot of deep frying. Information like this is of great value to those interested in improving fire safety. But it is information that will be lost to fire safety officers and local councils alike, if they don’t engage with the diverse communities that they serve.

Working together

It’s important to recognise that fire prevention is not something which can be done to a community. The community must join in and take part – it is a joint effort. In the disadvantaged area where I worked, people were very wary of dealing with public services any more than necessary. This meant that they were unlikely to engage with the local fire service, or with other groups attempting to promote such things as fire safety or healthier eating. And many of the reasons I heard for this were far less likely to affect more affluent, middle-class residents.

For one thing, the people I spoke with were fed up with nothing ever changing. They felt that they weren’t being listened to, and no matter what they said or did their lives stayed the same – so they had given up trying to engage with services. They also worried that having contact with one service would lead to unwanted contact with other services, with social services being a particular fear, as others have noted. And they felt judged – judged for needing help, judged for where they lived.

What’s more, fire was just not a priority. It seemed an unlikely possibility, set against all the other pressing problems they had to worry about, such as the bus service being withdrawn or the landlord not carrying out repairs. And for many, the prospect of engaging with local services to make their homes safer felt daunting. The language used by public sector workers was confusing. The way in which meetings were run was unfamiliar. Organisations dominated by middle-class, white employees tended to approach engagement in ways which make sense to middle-class white people. This created services which felt uncomfortable and unfamiliar to many of those who I spoke to.

If tragedies like Grenfell Tower are to be avoided in the future, public services need to get much better at engaging with the communities that they serve. And because those communities are diverse, the approaches taken to engage must also be diverse. Examples of valuable efforts I came across included hanging out in hairdressers frequented by African women, and working in partnership with an organisation with existing links to sex workers, to try to reach them.

Creating environments in which people from many backgrounds feel safe and comfortable engaging is a huge challenge for many in the public sector. It will push organisations out of their comfort zone. It will require time, investment and new skills. But these challenges can no longer be deferred, if we want to build a society which is fairer and safer for everyone.

Chris Hastie, PhD candidate, Centre for Trust, Peace and Social Relations, Coventry University

This article was originally published on The Conversation. Read the original article.

Barriers to engagement

Today my findings had their first big public outing when I presented at the Institute of Fire Engineers annual Fire Related Research and Development Conference. Here’s my presentation. Because it was the conference’s twentieth anniversary it begins with a brief look at the state of play for community fire safety 20 years ago, before running though the research I’ve been doing with communities in north east Coventry.

Or you can view it on

The presentation finishes with a couple of quite provocative questions. First, I ask whether the focus on very intensive Home Fire Safety Checks is the best strategy for ensuring a wide reach for community fire safety. And secondly, I ask whether Fire and Rescue Services are necessarily the best organisation to deliver community fire safety. I will return to these questions in more detail in future posts.


Factors associated with rates of fire

I’ve recently had an article published in the Fire Safety Journal1 which summarizes some of statistical research I carried out early in the project. This is my first academic paper to be accepted, so I’m quite chuffed to have managed to get through the peer review process. The article, bearing the not very snappy title of “Socio-economic and demographic predictors of accidental dwelling fire rates”, was co-authored with Professor Rosalind Searle and explores the way in which fires in the home are distributed through society.  Here’s a presentation that covers some of the main points…

If you have trouble viewing the presentation you can also try watching it on Vimeo

The published version of the paper can be found at doi:10.1016/j.firesaf.2016.07.002. Alternatively, you can read the accepted manuscript.

  1. Hastie, C. and Searle, R. (2016) ‘Socio-Economic and Demographic Predictors of Accidental Dwelling Fire Rates’. Fire Safety Journal 84, 50–56 DOI:10.1016/j.firesaf.2016.07.002 []

Plus ça change, plus c’est la même chose

I’ve rather let posts to this blog slip whilst I’ve been out talking to people and collecting data, not to mention listening back to all those conversations, reading field notes and trying to make sense of it all. But now, as the fog is just starting to clear, is perhaps a good time to return to it and start sharing some of things I’m finding.

Amongst the themes that are emerging is the fact that people really don’t think fire is all that important. A woman who has lived for sixteen years in an area with a particularly high rate of fires in the home told me that she had only ever seen one house fire. Against the perception that fire is a rare event that happens to others, people feel they have much more important things to worry about.

Another important theme centres around the failure of public services of all types to really get to grips with engaging effectively with some sections of a diverse community. For a whole range of reasons many people just aren’t interested in engaging with services, or hearing or acting on the messages they try to get across.

But what has all this got to do with the only bit of French I can remember—Plus ça change, plus c’est la même chose (the more it changes, the more it stays the same)? Well, I’ve been putting together a proposal for a conference paper recently, and the particular conference I’m hoping to present at celebrates its twentieth year this year. To mark this, the organisers are asking presenters to review the state of the field twenty years ago and relate their presentation to this. Community fire safety as a concept was in its infancy twenty years ago and the Home Secretary, who was responsible for Fire Services in those days, put together a task force to look at it. They published their report, Safe as Houses1, in 1997, and I dug it out to have a look at the other day.

And what do you know, they said pretty much the same things back then. On the perception of fire risk the report notes

The public in general feel remote from the dangers of fire. Only 4% of the public consider they are likely to have a fire in the home while the respective figures for burglary and
road accidents are 44% and 35%. Because of this, it is not ‘top of mind’

Elsewhere the report observes

Existing techniques and approaches have clearly not made sufficient impact on changing the attitudes and behaviour of those in greatest danger of having a fire in the home. Fire safety messages have not been heard or do not appear to have been acted upon by those most at risk

The authors suggest that the term “hard to reach” is inaccurate, arguing, in essence, that the groups they need to reach are reached easily because they watch a lot of TV. But they are hard to influence—they haven’t responded to the message. I think this distinction is somewhat artificial. If they haven’t responded you can’t really claim to have reached them. It remains the case 20 years on, though, that efforts to reduce the incidence of fire have been markedly more successful amongst some communities than amongst others. The message still isn’t being heard in some quarters. My job now is to work out why that is, and what can be done to change it.

  1. Community Fire Safety Task Force (1997) Safe as Houses: The Report of the Community Fire Safety Task Force [online] London: DCLG. available from <> []

Anatomy of a bend—the dangers of dehydration

Ask most divers what causes the bends, or decompression illness (DCI), and the chances are that the response will be along the lines of rapid ascent, or perhaps staying too long at depth. A factor that seems rather under appreciated, though, is just how much of a role dehydration can play in the development of a bend. I was told recently by a hyperbaric doctor that after rapid ascent, dehydration is the second most common cause of DCI. This is the story of how I came to be having that conversation with a hyperbaric doctor, just before I stepped into a recompression chamber to be treated for a bend. It’s also the story of another danger, denial. These two things, Dehydration and Denial, I’ve come to know as the dangerous Ds.

Feelin’ hot hot hot

Back in July Sophie and I set off to Stoney Cove for a day of fun diving. Armed with our shiny new drysuits we wanted to practice the skills we’d recently learnt in the PADI drysuit course. It was a gorgeous day, bright and sunny, 24°C in the shade, doubtless a lot more out in the sun. We planned to dive the Staingarth, a wreck at about 21m, and knew it would be a lot colder down there. About 11°C as it turned out. So I put on a full Thinsulate™ ‘teddy bear suit’ under my drysuit. I’d not used this undergarment before, having used a much thinner fleece suit during training. I knew it would be more buoyant than the fleece, so put on a bit of extra weight and planned a buoyancy check as soon as we got in the water.

It was hot in that suit in the bright sun. Really hot. We walked down to the water with our SCUBA, put on our gloves, hoods and fins and jumped. Quite why, having decided to do a buoyancy check, we didn’t take any spare weight with us to the water’s edge will forever remain a mystery, but that’s how it went. And you can probably guess what’s coming. I was under weighted. So I had to get out of the water and walk back to the car, in my already baking drysuit, with SCUBA and weights on, in the warm July sun, and fetch some more lead. By the time I got back in the water and had my weight trimmed I was absolutely roasted. Rarely have I been so relieved to jump into a cold quarry. We set off on the surface swim to the Staingarth buoy and began our dive.

Sophie at the Staingarth

Sophie in the Staingarth’s wheel house

It was a good dive and we enjoyed exploring the Staingarth. On the face of it the profile was pretty unremarkable from a DCI point of view. We descended quite slowly down the shot line and after exploring the Staingarth headed off along the bottom in search of the Wessex (which we missed). It was a fair stay at 21m, but should have been fine. The ascent was good and slow, taking nearly 3 minutes to get from 21m to 6m for a 3 minute safety stop before surfacing.

Back at the surface I took off my drysuit to find the undersuit absolutely drenched. My first thought was that the drysuit had leaked, but I then realised that the moisture was too evenly distributed, not concentrated around one point where a leak had been. It was sweat.

After lunch and a 112 minute surface interval we went for a second dive. This time I went for thinner undergarments, not least because the Thinsulate™ suit was still drenched. At the water’s edge I got a burst of cramp in one hand as I was trying to get my gloves on. Cramp is strongly linked to dehydration and I really should have heeded the warning sign. But I didn’t. We dived.

Another unremarkable profile. We dropped to 21m briefly to explore the Wessex, before coming back up to the ledge at about 6m and following that for the next 30 minutes or so—plenty of time to off-gas. But there’s more to a dive than the profile, and this one was full of problems. For me, all of them related to cramp. I had some of worse calf cramps I have ever experienced, at one point screaming in agony into my regulator whilst trying to massage them away. Perhaps the one good thing to come out this whole incident is discovering that I can have an experience like that underwater without panicking. It seems I perform well under pressure (credit to Dr Mike Gonevski for that cheesy pun!).

The first hit

I can’t really remember when the pains started, but over the next few days I began to notice deep, dull ’flu like aches in several joints—wrists, elbows, ankles and, oddly, the arch of one foot. They seemed to fade in and out, easing up in one place then coming on somewhere else. I was suspicious. I Googled DCI and read up on the symptoms. I looked at some of the dive forums. But I also really didn’t want to think it had happened to me. A combination of a seeming late onset, benign profiles, and the fact the pains kept moving helped me to convince myself that I didn’t have a bend. I left the pains untreated. After a week, maybe a bit more, they cleared up. I’ve since learnt that far from not suggesting a bend, pain migrating is actually a classic symptom of DCI.

Coming back for more

Fast forward six weeks and we headed back to Stoney again for my first dive since. This time a single dive, reaching 22m and then coming back up to 6m for the last 20 minutes. It wasn’t exactly a triumph of a dive—our communication was poor and my navigation even worse—but it was safe and sensible, with both our computers suggesting we had plenty of time left at 22m when we began our ascent. In the days to follow, however, the dull pains returned, this time focused in my wrists and thumbs. This was too much of a coincidence and when the pain worsened enough to wake me on Sunday night (the dive was on Friday) I guess I really knew what was going on. But by Monday morning it had eased off. It seemed such a trivial thing now that I couldn’t bring myself to disturb somebody’s bank holiday by making the call. My denial continued until late afternoon, when, pushed on by Sophie’s very sensible nagging, I called the Midland Diving Chamber.

Getting treated

I went through my symptoms and history on the phone with Dr Mike Gonevski, who quickly formed the view that I had had a dehydration related DCI back in July. Because it went untreated my redundancy had been diminished, so a fairly ordinary dive had brought about a recurrence. We arranged for me to go to the chamber on Tuesday for a full assessment and treatment.

Mug and book

The chamber goodie bag

The initial treatment followed Royal Navy table 66—a nearly six hour long session in the chamber starting off at 18m and then moving to 9m, breathing 100% O2 for most of the time. Yes, that’s right, a PO2 of 2.8bar. Sounds a bit scary when you’re used to thinking of 1.4bar as being the limit if you want to avoid oxygen toxicity, but as Spike, the tender who was in the pot with me, pointed out, there’s no risk of drowning in a chamber.

Whilst I can’t say my ride in the ‘big white bus’ was the most thrilling six hours I’ve ever spent it wasn’t nearly as bad as I thought it would be. All the staff at the chamber were fantastic—welcoming, friendly and reassuring. And I got to watch a Mock the Week video and eat a Thai takeaway, not to mention leaving with a souvenir mug and very amusingly written book on dive medicine. It’s certainly not something to worry about—far better to do it than not, as I’m discovering.

Had I gone there straight away in July there’s a good chance that first session would have sorted everything. But because I left things it’s become a lot more stubborn. I’ve been back for shorter (1h45) treatments three times1 since, and although I felt pretty pain free this morning I can feel it edging back as I type this. Denying what was going on was certainly not the smartest move I’ve ever made. But it is on its way out now, and I have to say a big thank you to Spike, Dave, Robbie and Dr. Mike for getting me there.

What have I learnt?

Beware the dangerous Ds!

  • Dehydration: do not underestimate the danger of dehydration and the role that it can play in the development of a bend. Keep hydrated. Learn to spot the signs of dehydration and call the dive if you suspect you, or your buddy, are affected. If you’re dehydrated a perfectly innocent looking profile can take you to the chamber.
  • Denial: do not deny that you have a bend. If you develop a pain shortly after a dive it needs checking out. Call the chamber. They don’t bite. Quite the contrary, they’re all really nice. And you may even get a takeaway out of it! At best, leaving things makes it worse and more difficult to resolve. At worst, it could kill you.
  1. Update 1 Sep 2014: now four times []

The mythical Green news blackout

Green Party supporters are upset. Apparently, the BBC are ignoring them. They’ve even set up a petition to demand more coverage from the Beeb, and my Facebook newsfeed is full of people encouraging me to sign it. I’ve a lot of time for the Green Party, but I’m not going to sign.

You see, I just don’t think there’s been a news blackout. The Greens are mentioned throughout the BBC’s election coverage. They’ve reported Natalie Bennett’s view that the Greens are now a ‘national party’ and her view that change is coming. With a quick search on the BBC’s website I found 21 news articles published today that mention the Greens. To say they are being ignored is simply a fallacy.

I do agree that they don’t have quite the coverage that UKIP have though. And here’s why—it’s quite simple really. They aren’t as newsworthy. News is about things that are, well, new. The Greens may have, as the petition points out, 178 council seats. But only 18 of them are gains over the position on Wednesday. UKIP, on the other hand, gained 161 seats. The fact is that both Independents and Residents’ Associations won more council seats than the Greens. Even the critique of media coverage by Another Angry Voice described their showing as “hardly an earth shattering performance”. Essentially, it was wholly unremarkable.

Look at the Greens share of the European Parliament vote in the UK. Yes, they gained one extra MEP, rising from 2 to 3. But their share of the vote is most remarkable for being almost exactly the same as it was last time. That really isn’t news. Jump, as UKIP did, by nearly 11 percentage points—and from a start of 16.5%, that’s a 66% increase—and you’re newsworthy. Get nearly wiped out, as the LibDems did, and you’re newsworthy. Achieve only a few moderate gains that basically leave you in the same position as before—a fringe party with a few localised successes—and you really can’t expect to make headlines.

The BBC’s editorial decisions have been entirely proportionate. UKIP’s gains are big news. And important news. News that we all need to hear and take notice of. News that should not be denied. The rise of the far right should be worrying every decent human being in the country. This is not the time to whinge about some perceived bias in the BBC. It is the time to look at what is happening, take stock and ask how can we ensure that UKIP’s game stops here.

Time for a change of image?

And for the Greens, it’s time to start asking what they need to do to move their game on. Here’s my penn’th. They need to change their image. Many will be screaming at that “it should be about policies, not image”. Well yes, it probably should. But it isn’t. That’s real life—get used to it.

Those who know that the Greens are a credible party with well rounded policies already vote for them. But for most of the electorate they are perceived as a single issue party focused on the environment, and perhaps a bit flaky with that. They are seen as middle-aged politicians who spent their youth living in yurts and buses. Their activists sit at elections counts knitting peace scarves. Not that there’s anything wrong with knitting peace scarves, but it is not an image that appeals to the majority of the electorate. And yes, of course the BBC could have chosen not to use that photo. Just as the activist could have chosen not to get her knitting out. The Greens need to learn to play the game. They need to find a way to get across to the wider electorate that they are not a single issue party. That they have credible policies that address the economy and society as well as the environment. And one thing that stands in the way of that is their name.

The pitfalls of joined up working

Joined up working—it’s all the rage in public management at the moment. It helps the public sector work more efficiently. It reduces duplicated effort. It enables multiple agencies to combine their resources and expertise to tackle those “wicked issues”—another big public management buzzword.

And on the face of it it all seems to make sense. In the context of fire, Merseyside Fire and Rescue Service has been doing interesting ‘joined-up’ work recently sharing data with a variety of other agencies to help identify, at an individual level, who is most at risk of fire1. This enables them to target fire safety interventions very precisely, which will surely mean better outcomes for less effort and cost.

As I’ve been reading around the subject of community relationships with public bodies, however, I’ve started to uncover bits of evidence to suggest that joined up working may not be entirely good for outcomes. It’s all to do with trust. Some really interesting research in Bristol has suggested that actually some communities, and particularly poorer communities, distrust the fire service2. This distrust hampers the ability of the fire service to communicate the  fire safety message and may be reducing the uptake of fire safety measures. And the suspicion is that it may in part be down to the fire service being associated in people’s minds with other public services.

The notion is explored in more depth in some earlier research into poor uptake of community health initiatives amongst those in more deprived communities3. The researchers in this study found strong evidence that people in poorer communities were reticent to engage with public services for a whole host of reasons. These included fear of loosing resources such as benefits, feeling they were being watched or judged, and poor experiences in the past, both of being treated without respect and of simply not getting the help they felt they needed. And crucially for the work being done by Merseyside Fire and Rescue Service, data sharing between agencies was identified as a significant factor leading to fear and distrust of the public services. This seemed to be particularly acute where Social Services were concerned, with the fear of having children taken into care widespread. Few would argue that protecting children isn’t important, but perhaps that purpose is not best served by an approach which is perceived as turning all public sector workers into spies, leaving parents afraid to engage with primary health care services.

There are certainly real benefits to be had by public services working together, but what is starting to become clear is that there are also some real problems associated with it. For all it may be done with the best intentions, some of the most disadvantaged people in society perceive joined up working by public bodies as a significant threat to them. As a result they make choices about the way in which they engage with services that may significantly hamper the ability of those services to achieve their aims. There are no easy answers. Abandoning joined up working is not a realistic option. But there is a clear need for public services to deepen their understanding of how their actions are perceived and how they affect the willingness of communities to engage with them.

  1. Higgins, E, Taylor, M, Jones, M and Lisboa, PJG (2013). Understanding community fire risk—A spatial model for targeting fire prevention activities. Fire Safety Journal, 62 (A): 20–29. DOI 10.1016/j.firesaf.2013.02.006 []
  2. Matheson, K (2012). Fire fighters, neighbourhoods and social identity: The relationship between the fire service and residents in Bristol [Online]. PhD Thesis, University of the West of England. Available from: [Retrieved 14 November 2013] []
  3. Canvin, K, Jones, C, Marttila, A, Burström, B and Whitehead, M (2007). Can I risk using public services? Perceived consequences of seeking help and health care among households living in poverty: qualitative study. Journal of Epidemiology and Community Health, 61 (11): 984–989. DOI 10.1136/jech.2006.058404 []

Google Drive and Linux

Google Drive is a handy way to share files across multiple computers, or back up files into the cloud. Naturally it integrates seamlessly with Android, and Google provide a client for use on Windows and the Mac, so you can keep you tablet, phone and PC all synced up. Unless you use Linux that is. Because unlike Dropbox, there is no official Linux client for Google Drive. Fortunately, help is at hand in the form of Insync.

Insync is a full featured proprietary Google Drive client. I’m focusing on Linux because it was trying to find a Google Drive client for Linux that led me to Insync, but it is also available for Windows and Mac. Unlike the official client, it supports multiple Google accounts, if you have a need for that sort of thing.

I have it installed on a laptop running Ubuntu 12.04 and it seems to do what it says on the tin. It constantly monitors a configured directory and keeps it in sync with my Google Drive account. It can handle having symlinks in the directory, so for example I’ve symlinked my Shotwell data directory to make sure that is backed up. And it can automatically convert Google format documents to LibreOffice format on the fly. It also supports selective syncing, allowing you to exclude certain folders from syncing. I’ve only had it installed for ten days or so, so it’s a bit early to tell if it functions reliably, but I’ve had few problems so far. The one niggling issue is that sometimes it fails to start at system startup, but support from Insync staff has been responsive so I suspect this will get sorted out soon.

Much Linux software is open source and distributed free of charge, so using proprietary, paid for software may come as a bit of a shock to some Linux users. If you have some deeply held philosophical objection to closed source this is not going to be for you, but otherwise it is definitely worth a look. The cost is far from prohibitive—the consumer version is $10 per Google account. When you consider that beyond the basic free allowance Google Drive is significantly cheaper than Dropbox you could quickly save this if you need more than a few gig of space. Cost over a year with 100GB of storage, including software purchase, would be $69.88 with Google + Insync consumer1, or $99 with Dropbox2.

If you want to try it out Insync is available on a 15 day free trial. To be honest, unless you make a lot of use of Google Drive this is not really long enough to evaluate something that just works away in the background. It’s also perhaps one place where the Insync team are missing a trick—it’s certainly not long enough to get you hooked. I suspect if they bumped this to six months they’d find a lot of people install it, forget about it, learn to take it for granted, and then pay for it a soon as they realise they’re about to be without it.

  1. Based on $4.99 per month + $10 for Insync. Google Drive price from, retrieved 24 Oct 2013 []
  2. based on $99 per year. Price from, retrieved 24 Oct 2013 []

Excuses, excuses

Most of us have done it at some time—when given negative feedback we become defensive and find excuses for the actions that are being criticised, or we turn it around and criticise those who are criticising us. Criticism is never easy to take. It’s an understandable reaction, and one that is just as common in organisations as it is in individuals.

A decade or so ago I was working for a large unitary authority when its first Comprehensive Performance Assessment (CPA) results were announced. They had been rated as ‘weak’—the second lowest of five possible ratings. Rather than acknowledge the failings and focus on how to improve, the initial response of the the Leader of the Council was to brand the decision as unfair and criticise the Audit Commission’s approach to assessment1.

More recently, the Francis Inquiry into the Mid Staffordshire NHS Foundation Trust noted that the Trust has failed to take notice of multiple warning signs and found a culture of defensiveness, inward looking and lack of openness to criticism to be major contributors to the extensive problems there. The report observes:

The Trust’s culture was one of self promotion rather than critical analysis and openness… It took false assurance from good news, and yet tolerated or sought to explain away bad news (para 1.7)2

and continues:

…the Trust was an organisation that lacked insight and awareness of the reality of the care being provided to patients. It was generally defensive in its reaction to criticism and lacked openness with patients, the public and external agencies (para 1.114)3

Denying criticism may not always lead to the atrocious failures that happened in Mid Staffordshire, where some reports estimate up to 1,200 patients may have died as a result4, but it is surely not the action of an organisation focused on learning and continual improvement.

Kolb's cycle of learning

Feedback informing Kolb’s cycle of learning
(adapted from Kolb5)

Feedback is a vital part of learning, whether that be for individuals or organisations. It illuminates our blind areas and increases our self-awareness6. It helps us to identify areas that need improvement that we may otherwise have missed. It can provide valuable information for reflection, feeding in to and complementing the cycle of learning described by Kolb7 (see figure). Today’s environment is in a constant state of change and organisations cannot afford not to be learning8. This requires an outward focus—the rest of the world is an essential learning resource—and a willingness to learn from mistakes9. Feedback, both good and bad, represents valuable external knowledge and a successful organisation will recognise this and be able to assimilate and apply that knowledge10. Organisations that have a strong learning culture accept negative feedback as willingly as they do positive feedback and use it as a source of reflection with a view to improving. In contrast, organisations that deny the validity of negative feedback are unlikely to learn from it and miss a valuable opportunity.

This is not to say that the targets of regulators and inspection bodies are always right. I’ve already noted some of the adverse effects that targets can have on organisational performance. But it would be foolish to throw out the baby with the bathwater. Even amongst a collection of seemingly meaningless targets the feedback about why those targets were missed may provide valuable intelligence that will help improve services further. Even if you don’t believe that what is being measured is useful, this does not mean that there are not valuable lessons that can be learnt from the process. The good organisation will not focus solely on the regulators’ targets—it will have its own more rounded concepts of excellent service delivery, seeing hitting targets as merely a by-product of being good at its core purpose. It will use any and all feedback that it can get to feed into the process of working out how to get better at that purpose.

Of course, getting negative feedback is not easy for employees who have worked hard to deliver a service. It is the job of leaders to maintain morale and to support the staff through this. This is not achieved by being defensive or drawing inwards. In the long term this only means the certainty of disappointing results next time too, and it sets a poor example for individuals’ learning. The leader’s role is to encourage, not stifle, learning11. Leaders need to work to establish a culture of continuous development, to emphasize the positives that can be drawn from learning and to motivate and empower employees to work together to find new solutions12. They should not be making excuses. They should put up their hands and admit the mistakes, and ask how they can do better next time.

  1. ‘Good’ – but not good enough (2002). Nottingham Evening Post, 12 December, p 20 []
  2. Francis, R (2013). Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: executive summary. [Online]. London: The Stationery Office. Available from: [Retrieved 23 April 2013] []
  3. Francis, R (2013). Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: executive summary. [Online]. London: The Stationery Office. Available from: [Retrieved 23 April 2013] []
  4. Smith, R (2009). NHS targets ‘may have led to 1,200 deaths’ in Mid-Staffordshire. The Telegraph [Online], 17 March. Available from: [Retrieved 24 April 2013] []
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