Morale and culture take a hit but PCH and RPH stand tall | AMA (WA)


AMA (WA) | Dr Todd Dennis

Morale and culture take a hit but PCH and RPH stand tall

Monday November 16, 2020

Dr Todd Dennis - Member, AMA (WA) Doctors in Training Committee

The annual AMA (WA) Hospital Health Check continues to place a significant emphasis on the twin issues of morale and culture in WA health system workplaces – and rightly so. A hospital’s performance in this area is assessed through questions pertaining to morale, engagement with hospital leadership, wellbeing support, and culture.


In the year of COVID-19, never has the perception of morale and culture held by doctors in training (DiTs) been more important, and the results reflect just how agile, adaptable and innovative hospitals can be.

The 2020 survey reveals an assortment of promising improvements, marked declines and ongoing stagnation throughout WA hospitals during the past year.

The clear standout is Perth Children’s Hospital (PCH), which has made a commendable improvement in all subcategories of the Morale and Culture aspect of the survey – the only hospital to do so – and climbed to the top score (A). It’s an impressive result and can offer insights and strategies for improving morale and culture across all hospitals.

As St John of God Midland Hospital takes its inaugural steps into the internship arena, and marks its second year as a HHC participating hospital, it continues to score highly across the board (B), with particular improvements in the DiTs’ perception of culture, and engagement with hospital leadership.

Royal Perth Hospital (RPH) has also maintained its reputation for morale and culture, enjoying a third consecutive year in the top spot (A). RPH’s nationally recognised Wellbeing program may have faced challenges with peer-support-groups moving into the virtual world in 2020, but the DiT view of morale and culture at RPH remains stronger than ever.

Although Joondalup Health Campus (JHC) continues to perform exceedingly well in all sub-categories of Morale and Culture in the HHC survey, it has experienced a slight drift backwards, from A to B. Yet the hospital has once again performed strongly when it comes to the DiTs’ perception of culture at their hospital, and in recommending this workplace to other junior doctors.

JHC is not alone in seeing gradual decline, with King Edward Memorial Hospital (KEMH) taking a step down from C to D. Encouragingly, Sir Charles Gairdner Hospital (SCGH) has seen a slight improvement in the perception of morale within the hospital, but has recorded an overall decline in the Morale and Culture section of the survey, slipping from D to F. Despite this, SCGH continues to fare well in terms of DiTs recommending their hospital to other DiTs.

Fiona Stanley Hospital (FSH) has had the most significant decline in survey results for Morale and Culture, falling from C to F. Although it scores reasonably well when it comes to DiTs recommending their hospital to their peers, FSH has scored lower in all subcategories compared to 2019 – with the largest fall recorded in the perception that DiTs have of wellbeing support.

Across all the WA hospitals that participated in the HHC survey, the common theme has been one of decline in Morale and Culture, with only RPH and SJG Midland continuing to perform well, and PCH being the lone hospital to improve from 2019. The survey has been completed in the context of COVID-19, and evidently, most hospitals have encountered difficulties in maintaining and improving morale and culture in such an environment.