Restorative justice for the NHS?

Fox_Kiyo ButterflyCan principles of restorative justice help rebuild trust when things go wrong in healthcare?

In a recent article in HSJ, Dr Mike Roddis asks whether principles of restorative justice – most famously used in South Africa’s Truth and Reconciliation Commission following the end of the apartheid era – might usefully inform the approach to restoring trust after harm in healthcare.

Restorative justice has proven a useful alternative to formal criminal justice proceedings, bringing offenders and their victims together in a way that has a profoundly beneficial effect on both. Similar principles, referred to as restorative practice, are also used in schools to restore harmony after conflict. When we look at how the Restorative Justice Council summarises the key principles, their applicability to restoring trust after harm in healthcare is readily apparent:

  • the primary aim is to repair harm;
  • there should be agreement about the essential facts of the incident and an acceptance of involvement by the person who caused the harm;
  • participation is voluntary;
  • the process requires acknowledgement of the harm or loss experienced, respect for the feelings of participants and an opportunity to consider, and if possible, meet their needs;
  • where amends are made the person harmed should be the primary beneficiary and this reparation should be acknowledged and valued; and
  • the person facilitating the process must act impartially

These are some of the principles I draw in on my approach to supporting patients and professionals after harm, an intervention that I call Restorative Review.

The principles are also embedded in the seven standards for restoring trust that I have developed in collaboration with Murray Anderson Wallace. These seven standards evolved out of my research into moral leadership, and from the testimony of patients and their families who had experienced (sometimes catastrophic) harm.

Using these seven standards and their detailed descriptors as a starting point, Murray and I have been working with NHS Trusts, the Care Quality Commission and other organisations to help them think about, develop and assess approaches to rebuilding relationships after harm.

Do get in touch if you’d like to talk about how we can support you.

Image: Butterfly by Fox_Kiyo via flickr CC: by 2,0