A recent Guardian piece exposed what many inside the NHS already know: a deep-rooted blame culture that leaves staff anxious, defensive, and afraid to speak up. It’s easy to dismiss this as a problem unique to healthcare – after all, lives are literally on the line. But look closer, and the same patterns echo across sectors: mistakes hidden instead of shared, learning replaced by self-protection, and psychological safety replaced by quiet compliance.
When fear becomes the management strategy, performance and wellbeing both erode. Teams spend more energy managing impressions than improving outcomes. Leaders feel pressure to “look in control” rather than admit uncertainty. And innovation flatlines because nobody wants to risk being wrong.
The Cultural Equation
Blame culture rarely begins with “bad people”. It begins with good people under pressure in a system that rewards control and punishes vulnerability. In the NHS, decades of reform, outsourcing, and scrutiny have created layers of accountability, but not enough trust.
Across UK organisations, data and national surveys echo the same trend:
- Only 52% of UK employees describe their workplace as psychologically healthy.
- More than 40% of employees say they’ve held back feedback for fear of negative consequences.
- And burnout, often a symptom of fear-based culture, remains among the top three causes of long-term absence in the UK (CIPD 2025).
From Blame to Learning
Building a learning culture means doing the opposite of what fear demands. It starts with three mindset shifts leaders can model immediately:
- Curiosity over control
Replace “Who did this?” with “What can we learn from this?” Curiosity de-personalises mistakes and keeps the focus on systems, not scapegoats. - Transparency over perfection
When leaders openly share their own missteps, and what they learned, they make it safe for others to do the same. - Repair over retribution
Accountability doesn’t mean punishment. It means taking responsibility and helping to repair impact. Teams that practise constructive accountability report 2x higher trust and 3x stronger engagement.
Building Psychological Safety (for Real)
Slogans about “safe spaces” don’t work if leaders’ behaviour contradicts them. Real psychological safety is built through consistent micro-behaviours: active listening, admitting uncertainty, following up after feedback, thanking people who raise concerns, and closing the loop.
Every time someone is punished, ignored, or quietly sidelined for speaking up, the organisation learns that silence is safer. Every time a leader responds with curiosity and care, it learns the opposite.
The Takeaway
The NHS article isn’t just a case study in crisis. It’s a mirror for all of us. When leaders trade fear for curiosity and reactivity for reflection, cultures shift. Mistakes stop being buried. Learning stops being optional. And people start feeling safe enough to bring their best, not just their safest, selves to work.