Organisational culture—the shared assumptions, values and beliefs that govern how people behave in organisations—is an important determinant of safety and productivity in healthcare. As healthcare systems face increasing demand, limited resources, and the need for high-quality outcomes, understanding how culture influences performance is essential.

In recent years, there has been growing recognition across the Irish health and social care system that organisational culture is fundamental to the delivery of safe, high-quality, person-centred integrated care. Responding to this imperative, the Health Service Executive (HSE) has developed this Enabling Framework for Organisational Culture, a strategic and values-driven guide designed to support our regional and national teams in understanding, shaping, and strengthening their cultural foundations. Rather than prescribing a one-size-fits-all model, the Enabling Framework provides a structure that encourages local adaptation to and integration with existing initiatives. It lays out a clear set of guiderails to ensure that the core values and behaviours remain consistent and aligned across all of our services and sites. It promotes a learning-oriented, inclusive and compassionate approach to culture change, placing people—both staff and the public—at the heart of the transformation journey.

Organisational culture is a powerful force that shapes behaviour and outcomes, and if left unattended, it will evolve organically, potentially in ways that are not aligned with the organisation’s vision, mission and goals and indeed the ambitions of SláinteCare. Leaders have a responsibility to actively shape and guide our organisation’s culture, rather than passively allowing it to develop on its own. The framework emphasises the importance of leadership, psychological safety, reflective practice, and shared values in enabling sustainable cultural transformation. It also provides an intentional, programmatic model to establish and oversee organisational culture development work and has established a group to research, develop and monitor metrics that will enable the system to identify where it is on its culture journey. Key stakeholders will be able to measure improvement in our culture in tangible real terms that are aligned to key outcomes with a strong evidence based analysis.