In pursuit of a culture of continuous improvement: Scotland’s national ambulance service

This case study explores employee perceptions of, and commitment to, continuous improvement in a national public sector organisation. The survey of 593 employees is analysed across four management levels and evidences the employees desire to deliver service improvements and their frustrations across different levels of feeling unsupported and impacted by negative management behaviours. The study shows the areas where there are clear differences between organisational level, sub-cultures and individual commitment around motivation. The findings inform the need to go beyond a simple CI initiative no matter how well structured, ensuring all policies and practices support and reflect the need to shift culture to embed continuous improvement.