BMJ Values assurance: feedback and recommendations BMJ is committed to its values and the role the values can play in the organisation’s success. We recognise that BMJ has taken great steps to embed its values into the organisation and maximise their effectiveness since they were introduced in 2013, and has had success through these measures. These steps include, but are not limited to, the use of values champions, senior executive communications around values, visual reminders of the values throughout offices, and the embedding of values into business processes such as recruitment, appraisals, and some decisionmaking. BMJ’s success in embedding its values and maximising their effectiveness notwithstanding, our assurance process and observations has led us to the following recommendations for further progress: 1. Articulating the role and meaning of the values at the individual and departmental level. Whilst people generally had a strong understanding of the meaning of the values for the organisation as a whole, this strength of sentiment does not filter down as strongly to the departmental nor individual levels. This is unsurprising as different values will have a more natural fit with different teams, individuals, and roles. That said, there may be scope for departmental and team leaders to play a greater role in helping individuals and teams connect the work they do to each of the values. 2. ‘Improving healthcare is difficult and requires courage’ and ‘Patients come first’. These two values were often the values that individuals struggled to resonate with in their day-to-day activities. This is because the BMJ does not deal directly with patients, and some employees feel that they are disconnected from frontline healthcare workers who directly improve healthcare. What is clear is that people agree with the sentiment of these two values and that, more broadly, they are statements about healthcare that the BMJ believes in. BMJ could consider how to articulate this further in order to help people to understand the role they play in improving healthcare and putting patients first. BMJ could do this through getting senior figures from the executive or editorial team to explain their viewpoint and experience of these values, and how they relate to the organisation as a whole. This could be done at BMJ’s ‘Lunch and Learn’ or Town Hall events. In addition, BMJ could increase its use of employees as patient reviewers of content so as to increase their exposure to these two values. 3. The values as a decision-making tool. One sign of the values being fully embedded into the organisation, would be that they are clearly used as a decision-making tool. Whilst we saw some evidence that this was the case, BMJ could consider how it can best empower its employees to use the values more readily as an everyday decision-making tool. BMJ could engage with

and/or benchmark itself against other values-driven organisations to further understand how values could be woven into decision-making processes so that people conscious apply the values when taking action, or challenging the decisions of others. 4. Balance in mainstreaming the values. Whilst BMJ could still make further progress on embedding and promoting its values internally, there is an inherent risk in any such undertaking that employees will become desensitised to the activity and its purpose. It is therefore important for BMJ to strike the right balance in its activities to embed the values and engage employees on them. In order to effectively strike this balance, BMJ could consider monitoring the effectiveness of different types of engagements around the values and prioritise the most effective. 5. People need ownership of the values. There was some sentiment from our engagement that the values are seen as a relatively top-down initiative. For the values to become truly embedded and therefore effective, BMJ could put greater emphasis onto bottom-up ownership of the values. This will allow the values to develop organically. This could lead people to feel a greater connection to the values in their everyday role and a greater connection between the values and their role. Teams within BMJ could hold a series of ‘values sessions’ to help generate ideas around how the values apply to their team and the work they do. BMJ could also consider further embedding the values into the appraisals process. In addition, when BMJ repeats its values survey next year, it could ask employees how they see themselves taking ownership of the values. 6. Overall impact of the values. BMJ’s values have been in place for over two years now. From our assurance process, in particular the survey, it is clear that people are broadly aware of the values and understand them. In light of this, BMJ could consider the question, “what does this mean for our organisation?” It could seek to answer this question by evaluating and monitoring the impact that the values have on the organisation as well as its relationships externally: for example, what impact have the values had upon commercial relationships or employee engagement levels? Crucial to this undertaking would be that responsibility, understanding, and ownership of the task was shared throughout the whole organisation. BMJ is considering creating a data dashboard around its values with specific KPIs underlying each value. We encourage BMJ to pursue this idea and encourage BMJ to closely monitor progress against the KPIs to ensure that they remain relevant.