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How to address bullying and harassment at work

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Around one in five doctors in the NHS say they have been bullied or harassed by managers or other staff in the past year.  Most incidents go unreported, often because staff believe nothing will happen or they are afraid to raise concerns.

The BMA is committed to raising awareness of bullying and harassment and the consequences for doctors’ well-being and patient care. We want to ensure there is a clear understanding of the issues and people are confident to raise concerns and report problems when they do occur.

Find out more below about what constitutes bullying and harassment, what to do if you are being bullied and what to do if you witness it.

 

  • What is bullying and harassment?

    Bullying and harassment can be obvious, with openly aggressive, humiliating or insulting behaviour. But sometimes it manifests itself in more covert ways making it harder to identify.

     

    Examples of bullying or harassing behaviours

    • Physical or verbal abuse that directly attacks or ridicules a colleague
    • Inappropriately criticising or humiliating a colleague in front of patients or colleagues
    • Regularly ignoring a colleague and excluding them from meetings or events.
    • Making derogatory comments or offensive jokes about women, disabled people or people of a particular race or faith background, sexual orientation or age
    • Inappropriate touching, sexualised comments or trying to elicit sexual favours through threats or promises
    • Using threats (e.g. about job security or patient care) to get someone to comply with work demands
    • Setting someone up to fail by overloading them, giving inadequate support and blaming them for failure afterwards
    • Constant criticism, excessive scrutiny and micro management of tasks.

     

    What constitutes bullying and harassment?

    Bullying

    There is no legal definition of bullying but ACAS defines it as:

    "Offensive, intimidating, malicious or insulting behaviour, an abuse or misuse of power through means that undermine, humiliate, denigrate or injure the recipient.”

    Employers have a duty of care to employees and a duty to protect their health and safety at work, including protecting them from harmful acts like bullying.

    The effect of behaviour on the recipient is key to identifying whether bullying or harassment has taken place. This is why, when it comes to preventing bullying and harassment, it is important to reflect on how our behaviour is received by others.

    Harassment

    The Equality Act 2010 defines harassment as unwanted conduct that is related to a protected characteristic (age, sex, disability, gender reassignment, race, religion or belief or sexual orientation) or unwanted conduct of a sexual nature. It has the purpose or the effect of violating someone’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for them. Harassment is unlawful.

    Bullying or harassment is often top-down but it can occur between peers or be upwards from junior to senior staff. It may be one-on-one or it can be a group of staff bullying or harassing a colleague or another group.

     

    If you are a BMA member who is affected by bullying and harassment at work, you can contact us at any time to talk through the issues.

    For advice and information contact 0300 123 123 3  or email us.

     

  • The impact of bullying and harassment

    Bullying and harassment causes stress and can result in physical and mental health problems. It damages morale and undermines team work, leading to poor performance. Ultimately bullying someone puts patient care and safety at risk.

    Someone who is bullied or harassed at work is likely to experience one or more of the following:

    • anxiety,
    • difficulty sleeping
    • loss of appetite
    • inability to switch off from work
    • self-doubt, loss of confidence
    • feeling isolated
    • hyper-vigilance or a need to constantly double-check your work.

     

    The impact of bullying on patient care

    The GMC has said that “Bullying and undermining are completely unacceptable and can have a big impact on the safety of care given to patients."

    Humiliating, degrading or shaming behaviour will create intense feelings of fear, anger, shame, confusion or self-doubt which will significantly affect a person’s ability to think clearly and make errors more likely.

    It is natural for people to avoid approaching a colleague who is disrespectful or bullying to ask for their help or to seek clarification of instructions, which again puts patients at risk.

    Disrespectful behaviour and poor communication between co-workers is likely to be mirrored in how patients are treated too.

     

    If you feel you are being bullied, whether or not you are a BMA member, please call our professional and confidential BMA counselling and Doctor Advisor service on 0300 123 1245  to get support, 24 hours a day, 7 days a week.

  • When does performance management become bullying ?

    Sometimes a response to an accusation of bullying by a manager or more senior colleague is that they were just managing performance.

    However, an effective manager will:

    • Clearly communicate what is expected in advance
    • Apply performance standards in a fair and consistent way
    • Discuss any performance issues in private with the relevant members of staff
    • Give constructive feedback and set out the necessary steps for improvement
    • Be willing to listen and understand what may lie behind any performance problems
    • Provide appropriate support and opportunities to improve before taking further action. 

    They should not:

    • Constantly change the goalposts
    • Be inconsistent in how they deal with performance issues or show favouritism
    • Criticise, humiliate or undermine staff in public
    • Jump to conclusions and seek to blame others for failures
    • Immediately threaten or take disciplinary action without first offering appropriate support and a chance to improve.

     

  • What to do if you are being bullied or harassed

    Talking things through with a friend, family member, trusted colleague or a BMA adviser will help you identify the problem, give clarity about the issues and start to build your confidence to deal with it.

    Sometimes just making the person responsible aware of the impact their behaviour is having on you is enough to stop it, particularly if it was unintentional. If you take this approach, prepare what you are going to say beforehand, stay calm and be clear and firm when you speak to them.

    However, you may not feel confident enough to speak directly with the person responsible, especially if you have experienced bullying or harassment over a sustained period.

     

    Other steps you can take

    • Keep a diary. Try to record things soon after they take place, noting down the dates, times, places, who was there, how you felt and any action you took in response. Stick to facts and keep things short and simple. This will give you clarity and provide evidence for others.
    • Familiarise yourself with your employer’s bullying and harassment or dignity at work policy.
    • Make your employer aware of the problem by speaking to your line manager or, if they are the person bullying or harassing you, a more senior manager or HR. Some employers have identified individuals who staff can raise bullying and harassment concerns with on a confidential basis too.

    Your employer may offer to speak informally to the person responsible. If they do, clarify how they will do this, what they will say and what the expected outcomes might be. They may also offer voluntary mediation to resolve the problem. This can have positive results if it is entered into in good faith by all parties, with full knowledge of what it involves, and is carried out by a trained, independent mediator. The BMA can provide you with more information, advice and support about these options.

    If informal routes for dealing with the problem have not worked or are not appropriate because of the severity of the bullying or harassment, the next step is to make a formal complaint and a formal investigation should follow. Before submitting a complaint, it is important to speak to a BMA adviser who will be able to advise you on the best way to do this and support you throughout the process.

     

    If you are a BMA member who is affected by bullying and harassment at work, you can contact us at any time to talk through the issues. For advice and information contact 0300 123 123 3  or email us.

  • Someone I know is being bullied what can I do ?

    Doing nothing about bullying or harassment can be seen as endorsing it.

    If it is not addressed, it can become the normal way to behave or get things done, especially if it is perpetrated or tolerated by managers or senior staff.

    If you need more help on identifying and tackling bullying in the workplace see the BMJ online learning module.

    If you witness or suspect that bullying or harassment is affecting a colleague, speak to them to clarify things and signpost them to support.

    If bullying behaviour from a colleague is unexpected or out of character, talk to them to find out if anything is wrong. There may be underlying work or personal issues that they need support with. The BMA can provide counselling support to members.

    Or it may be appropriate for you to report and take action yourself, especially if you are in a management or senior position.

    Keep a record of what you see, familiarise yourself with your employer’s policy and speak to one of our advisors for further advice.

    Contact 0300 123 123 3  or email us

  • What the BMA is doing about bullying and harassment

    The BMA has joined NHS organisations and other health unions in endorsing a collective call to action to tackle bullying in the NHS and to create a more supportive workplace culture.
    Find out more about it

    If you are a BMA member who is affected by bullying and harassment at work, you can contact us at any time to talk through the issues.

    For advice and information contact 0300 123 123 3  or email us for employment advice and information.

    You will be given initial guidance on the issue. If there is particular support we can provide locally, you will be transferred to a relevant adviser in your local area.

    BMA Scotland has launched a Respect at Work project, which means if you are in Scotland you can email us to access advice and talk through your option.
    Find out more about Respect at work

    If you are a BMA member and GP employer or practice manager dealing with bullying or harassment issues, our Employer Advisory Service (EAS) can also provide support. Call 0300 123 1233.
    Read more about EAS

     

    Promoting a positive work environment

    Everyone has a role to play in creating a positive working environment and setting standards of professional behaviour. Simple things like talking calmly and politely to colleagues, thanking people for their help and recognising the contribution of other team members are important.

    Read our guidance 
    Promoting a positive working environment

  • Further resources