In this cluster we define both ‘Culture’ and ‘Subculture’.


Culture is the shared tacit assumptions of a group that it has learned in coping with external tasks and dealing with internal relationships.

Source: Schein EH (1999) The Corporate Culture Survival Guide. John Wiley & Sons. Page 186.

Example of the term in use:

… compassionate leadership in particular is a fundamental enabling factor that will create a culture of improvement and radical innovation across health care.

Compassionate leadership enhances the intrinsic motivation of NHS staff and reinforces their fundamental altruism. It helps to promote a culture of learning where risk-taking (within safe boundaries) is encouraged and where there is an acceptance that not all innovation will be successful – an orientation diametrically opposite to a culture characterised by blame, fear and bullying.

West M, Eckert R, Collins B, Chowla R (2017) Caring to change. How compassionate leadership can stimulate innovation in health care. The King’s Fund. May 2017. Pages 1-2.


Complex health care organizations are likely to comprise a number of coexisting subcultures. While these may share some common orientations and similar espoused values, they may also diverge and clash or maintain uneasy and shifting tensions. Traditionally in the NHS, organizations such as hospitals have been clearly differentiated along distinctly occupational lines and these may give rise to a wide range of non-mutually exclusive subcultures in terms of clinical specialism, department, ward or clinical network affiliation.

Source: Konteh FH, Mannion R, Davies HTO (2010) Understanding culture and culture management in the English NHS: a comparison of professional and patient perspectives. Journal of Evaluation in Clinical Practice 17: 11-117. doi:10.1111/j.1365-2753.2010.01376.x

Example of the term in use:

In medicine, subcultures tend to develop around specialties. The three specialties in our research population, anesthesia, surgery and nursing, require different skills and training. The members of each group differentiate between themselves and members of the others. Stereotypes held by medical personnel about other specialties are strong and occasionally pejorative.

Helmreich RL, Merritt AC (1998) Culture at Work in Aviation and Medicine. National, Organizational and Professional Influences. Ashgate Publishing Ltd. Page 40.