Organisational culture and change support

Organisational culture is the pattern of shared behaviours, beliefs, relationships and unwritten rules that shape how work actually gets done. It is not the values statement on the wall. It is what happens when someone raises a concern, when a deadline slips, when two teams disagree, and when nobody is watching.

Because culture lives in everyday interaction, it shows up in things organisations already measure: retention, engagement, absence, complaints, quality of service or care, and how well change lands. When those indicators move in the wrong direction together, it is usually a culture signal rather than a series of unrelated problems.

Culture, employee experience and engagement

These terms are often used interchangeably. It helps to separate them. Employee experience is the sum of everything a person encounters at work, from recruitment and onboarding to development, technology, workload and how their manager behaves. Engagement is one outcome of that experience — how connected and willing to contribute people feel. Culture is the underlying system that produces both.

One of the most telling markers is whether people would recommend their organisation as a place to work, or recommend its services to someone they care about. That single question shapes reputation and recruitment long before it appears in a survey report.

That is why engagement scores rarely improve for long through engagement activity alone. Sustainable improvement comes from changing the conditions that created the scores.

Diagnosis is not about producing a verdict. It is about exploring the culture as it is experienced now, from a range of perspectives — because our own experiences shape the view we each hold. Change can only really happen when there is a shared understanding of the starting point, and that understanding has to be one people recognise as true.

Louise draws on evidence-based tools and approaches, alongside:

• The data you already have: engagement results, retention and turnover, exit interviews, absence, complaints, incidents, quality and performance information
• Structured conversations, focus groups and listening sessions with people at different levels and in different roles
• Observation of how work really happens — meetings, handovers, decision-making and escalation
• Attention to systems and processes that quietly shape behaviour, such as appraisal, reward, rotas, workload and how concerns are handled

The output is a clear narrative with themes, evidence and specific, prioritised areas to work on — written in plain language, and designed to be shared with the people it describes.

Collaborative change and involvement

Once there is a shared picture, the work shifts to what happens next. Yew Thrive facilitates sessions where leaders and teams co-design the cultural vision and the specific behaviours that would make it real, then decide who will do what and how progress will be visible.

The best change is done with people, not to them.

Involvement is not a nice-to-have here. It is the mechanism. People who help shape a change are far more likely to sustain it — and they notice things an external consultant never will. Louise's role is to create the conditions for those honest conversations, hold the structure, ask the difficult questions, and make sure the work reaches practical action.

Yew Thrive is led personally by Louise Pramas MA, FCIPD, ILM7. You work directly with Louise, who has spent more than 18 years in senior leadership roles in the NHS in England, specialising in organisational development, staff experience, positive people management and culture transformation.

Most recently, in a national culture transformation role at NHS England, Louise supported organisations and Integrated Care Systems through culture change journeys using evidence-based approaches, coached senior leaders and programme leads, and facilitated workshops to co-design cultural visions and supporting behaviours. She contributed to national policy including the NHS People Plan for England, the NHS 10-Year Workforce Plan and the NHS Staff Standards for England, and has led revisions to the NHS Culture and Leadership Programme since 2020.

That means senior organisational expertise, applied with care. Yew Thrive is values-led, evidence-based and unusually focused on leaving internal capability behind — because the measure of good culture work is what continues after it ends.