Last updated:

Bullying and harassment in the NHS: policy recommendations

The BMA began its bullying and harassment project in 2017 following SAS doctors highlighting the impact that bullying and harassment had on the working lives and well-being of members, and growing evidence of how it harms patient care and safety.

We reviewed the existing evidence on workplace bullying and harassment in the NHS, and asked doctors and medical students to share their experiences with us.

This report is a reflection of what we have learned. It sets out key issues that need addressing, and recommendations for change.

Download the report

 

Our recommendations

The recommendations below should target bullying and harassment at all levels, including:

  • changing individual behaviour;
  • addressing the organisational factors;
  • and dealing with system pressures.
  • End the silence

    • Talk about behaviour and improve understanding of what constitutes bullying and harassment.
    • Make sure there is a designated person who people can discuss bullying or harassment concerns with informally and in confidence.
    • Improve awareness and reach of Freedom to Speak Up Guardians where they exist.
    • Use anonymous surveys and other feedback to assess the prevalence and nature of bullying and harassment concerns in workplaces.
    • Encourage bystanders to be more active when they witness bullying and harassment taking place.
    • Give people the tools and support they require to effectively challenge behaviour that is bullying, undermining or harassment.
  • Improve resolutions

    • Improve how formal complaints are handled in practice in the NHS, ensuring sufficient resources, representation and support for individuals going through the process.
    • Ensure access to alternative means of resolution, such as mediation, where appropriate.
    • Encourage and enable early intervention to tackle low-level unprofessional behaviour before it escalates to bullying or harassment.
  • Create a supportive and inclusive culture

    • Alleviate the system pressures and take steps to support the development of positive working relationships.
    • Display compassionate leadership from the very top and develop it throughout the NHS system.
    • Embed an understanding of human factors in medical selection, education, training and work practices.
    • Provide more training and support on giving and receiving effective feedback.
    • Improve support for doctors and medical students with disabilities or long-term health conditions.
    • Value diversity, support diverse teams, and ensure inclusion of all staff.
  • Resources

  • Related work