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More than a fifth of doctors and dentists say that they have experienced bullying, harassment or abuse from other staff in the past 12 months, according to last year’s NHS England staff survey.
This may be a statistic that surprises you. Or, like me, it may come as no surprise at all. Many of my fellow SAS doctors report even higher levels. More than one in three SAS doctors in England and even more in Wales have told us they’ve experienced it.
If you have seen instances where colleagues have been bullied or harassed, or if you’ve been on the receiving end yourself, did you do anything about it?
NHS staff surveys show that only a minority of doctors formally report incidents of workplace bullying and harassment. Only one in three of the doctors who said they’d experienced it in the NHS England staff survey said that they or a colleague had reported it. This is significantly below the level for all staff. Junior doctors are even less likely to report incidents. Only one in four do so.
Why are reporting levels so low? Worryingly, the main reasons given by doctors are that they don’t believe it will make a difference or that they fear the repercussions of reporting.
We’ve been talking to members from all branches of practice about bullying and harassment over the past few months and these findings have chimed with many. We’ve also reviewed the evidence to try and get a better understanding of what causes bullying and harassment, how it affects doctors’ morale and well-being, and how it impacts on patient care and safety.
The research suggests a combination of factors feed into creating environments which permit and perpetuate bullying behaviour: the organisational culture in the NHS; workload pressure; the strong hierarchy within the medical profession; and the ‘silent bystanding’ which means behaviours go unchallenged and become learned by newer staff.
Ending bullying and harassment, which means addressing these underlying factors, is a big challenge. It is not something we can do on our own. We need the support and commitment of senior leaders, employers and other staff groups to really make a difference. But that doesn’t mean we should just put our heads down and accept it until someone else takes the initiative. We must do what we can now and we must be part of a collective effort to change things.
Last year, doctors at the BMA annual representative meeting called on the association to do more to tackle bullying and harassment within the doctor workforce. As chair of the representative body, I am pleased to announce that the BMA has initiated a cross-organisation project.
We began work earlier this year, engaging with members and reviewing the evidence and the guidance we provide. In the coming months we’ll be raising awareness of what bullying and harassment are and to help members understand what they can do, whether they have been victims, bystanders or someone who may be accused of bullying.
We will be working to influence others too, sharing what we have learned from our members’ experiences and pressing for change in workplaces and the wider NHS system.
The BMA has endorsed NHS England’s Social Partnership Forum’s ‘collective call to action’ to actively tackle bullying and harassment at all levels and BMA representatives are involved in regional SPF initiatives. Action is underway in the devolved nations too. It’s been a priority for BMA Wales and they’ve played a role in securing important changes there. And, earlier this year, BMA Scotland launched a new Respect at Work helpline for members. Over the course of the project we’ll bring together these experiences and hope to spread across the organisation the lessons learned about what makes a difference.
If you have anything you wish to share that may be beneficial please contact the BMA’s equality, inclusion and culture team at [email protected].
Let’s put a stop to this together.
Anthea Mowat is chair of the BMA representative body
Read more about the BMA initiatives to promote dignity at work.
Failure to understand the duties of SAS doctor and the seniority level as they pass through their thresholds is a major contributor to this .
Some consultant still see SAS doctors a juniors despite being beyond threshold two which according to the royal college of surgeon should have duties which mirror that of consultant .
The cycle of SAS doctors keeps repeating each time new consultant is appointed who disregard previous experience of the SAS doctors.
To be considered experienced or not is still at the consultant leisure to give it take.
This has an impact on every day work and on job planning.
This needs to change
It is superb that you have tried to improve this Anthea. Sadly the juniors in training posts need strong will to fight against a system that is very much against them. This is fact sadly. However hopefully in my life time this culture will change. Bullying is much higher than a 1/5. This is an example of how Drs are even scared to report it. The GMC survey is also pointless as if you report it then they tell you they might need to investigate it. I had 10 drs come to me to express concern of bullying. Only 2 were willing to report it.......... Good luck
A big problem indeed is the silent bystander, not wanting to get involved or not caring when someone is distressed or unpopular because of perhaps being marred by association. Shunning the person being ‘bullied’ perhaps because it might impact on their career or associated activities. Turning a blind eye, or using the situation to their own advantage. There are so many forms of bullying and harassment including excluding someone professionally and personally, being afraid of not being one of the incrowd if you get involved or are seen to be ‘friends ‘which the scapegoat. Of course it eventually drains any enthusiasm or effort out of that person and makes working life a hell and can have lasting effects on health and well-being. There are so many people in the nhs who are more concerned about their own career and social or professional standing. Invariably they are often the people who jump on the band wagon of righteousness to further themselves yet again after the event. I doubt you will overcome the ingrained hypocrisy and false campaigns of concern that continue to prevail without a complete change in outlook.
You have highlighted the issue of bully and harassment in the NHS affecting all the Drs but mostly the SAS Drs which is also evidenced by two recent BMA survey run by SASCUK.
Our survey clearly demonstrated who are the perpetrators and while BMA is launching some activities eg online module to tackle B&B, promoting dignity at work, A cross branch workshop/ conference on this topics and find a collective way tackling this, would be good. I remember that the previous chair of CC acknowledged to me that there is an issue and CC and SASCUK should have done formal discussion but never got materialised.
We need to do lot of hard work to educate, train resilience to all Drs particularly SAS Drs who are mostly affected and bring those perpetrators to justice and highlight as examples to prevent this happening.
We need to create a culture of mutual respect and SAS Drs need to keep their head high, chin up and fight back or challenge any act of B&H.
Thanks for your timely needed blog.
With warmest Regards.
Some advice to victims of workplace bullying.
A large institution can and readily WILL do its utmost to avoid the stain on its reputation of harbouring a bullying problem. So, a complainant will potentially have odds stacked very heavily against them as bullies, co-bullies, and managerial systems join forces in what will usually be a very painful, prolonged and expensive process. The energy needed to prevail against a cunning and powerful bully, often a person of huge influence, can be more than most can muster while trying to sustain a career and any semblance of work-life balance. Sorry to appear a pessimist, but simply having a 'Dignity at Work' policy is insufficient protection for the average employee. Anyone setting up to make a formal complaint must prepare carefully and have on board solid and respected allies, and do the research. There are stereotypical behaviours, and personality traits which are hallmarks of the serial workplace bully, which I for one was not educated about, before the event.
Also, before raising a complaint, have an escape plan.
A little too late to try and turn the tables for a number of promising people, Consultants, trainees and SAS colleagues who have knowingly experienced continued insidious undermining or the turning a blind eye technique or even the odd contribution from those who profess to be champions of good causes. There will always be people in a position of power who profess to find this issue abhorrent and there will always be people clambering over one another to get up the greasy career pole. All helps the CV and self worth though to do a survey and get someone to lead another campaign.
I am taking up a similar fight for justice at my organisation. The culture of fear and bullying has to change and it has to change from the top! The question is "who manages the managers?". I will continue to fight for dignity at work, for equality, and to end the bullying culture!
This is very close to my heart and I strongly believe that much needs to be done to improve working environment. Am very glad that the BMA is taking this up in a big way. Thanks to them for providing the victims a forum to raise this issue which demeans the victim.
The reported incidence is high., but, in my opinion the problem is far bigger. The staff., including Doctors need to understand as what constitutes Bullying and harassment. In my view., the victims do not know that they are being subjected to this very primitive form of coercion and submission.
As proposed last year., I strongly urge the BMA to make understanding Bullying and Harrasment as a mandatory training.
All the very best in your efforts.
The comment "Some advice to victims of workplace bullying" eloquently described NHS bullying at it darkest. All I can add is that the concept of the workplace psychopath also needs to be out in the open.
Anonymous 's comment : advice for victims of bullying is insightful - this is not a simple concept.
Bullying is rife, it backs up poor care, manipulated outcomes, many getting on with their work and keeping their heads down. The reality is that the BMA expends a lot of effort on a lot of topics which are less crucial to the welfare of their members and tangential to the patients cared for by members almost entirely within the NHS, some examples are in this letter. SAS doctors suffer more than most but are hardly the only victims. The BMA should tackle the fact that Medical Managers are the main perpetrators, indeed often Medical Directors and Responsible Officers. One of the Prime Tasks should be to work on /with the GMC to make Responsible Officers stand alone Guardians of Standards re Practitioners and how that translates to patients ie Senior Doctors impervious to the bullying by Medical Managers especially Medical Directors and who bypass them and go straight to the GMC, The obverse is that if one was to complain about the bullies to the GMC the Medical Director will tell the GMC that the perpetrator is a good chap or chapess especially if a Medical Director is the bully as RO they are the CMCs chaps in the periphery. More pertinent would be an NHS authority to deal with bullying allied to NCAS.
In our Trust CD and Medical director and head of service posts are appointed and not elected by Doctors. So instead of being the link between clinical and management entities of the Trust. I feel that they are just tools to enforce the Management will on clinical staff. This reflects on wide range of dicision that from the management point are great but from the clinical point are not and if the clinical staff voice their concern they are bullied.
My Clinical Director told me that I was good for nothing and not fit for purpose after 33 years of work and commitment to the profession and patients' welfare. The BMA has done nothing to the date despite of numerous letters I have sent to the BMA themselves. My very feeeling is that the BMA is not protecting doctors at all, but it is siding with the perpetrstors of the bullying themselves. I got a lot of evidence to prove the above, so much so that despite of being the member of the BMA since 1996 I had to resort to an another legal body to resolute the situation. In my particular situation the BMA has proved totally useless and I strongly believe that many other doctors woyuld share the experience. By the way. did you know that as many as 28 doctors have commited suicide through the GMC investigations since 2012 and no audit has been done on the matter to the date. This has made the doctor's profession in this country a very dangerous one; statistically even more dangerous than the test pilots' one.
So as long as the BMA is only words and not an action this trend is going to get much worse and I can only say that the very profession is in much worse turmoil than it is presented publicly.
Bullying has won in my work environment. It is seen as THE way to manage staff including doctors. Formal reports are ignored and those writing them are bullied by the investigators. Doctors now line managed by non-doctors. Patients and staff suffer. I would never encourage someone into the NHS the risk of ill health is too high. CQC do nothing except note poor staff morale and 60% staff afraid to raise clinical concerns. In the meantime the CEO gets awards!
I made the posting entitled 'Some advice to victims of workplace bullying', and must express my gratitude to supportive comments and especially to Anthea for progressing this project.
Yes this is a serious problem and indeed far from simple, but most importantly it is a very dangerous one impacting heavily on victim health and patient safety.
I want to add something. While initiating a formal grievance process directed against a serial bully, we took the unusual step of discussing our 'little problem' with a professor of psychology. We were particularly interested to have insight into how that particular personality type might behave when cornered inside formal process; baited even.
The opinion which came back after a long discussion was startling. 'Be very afraid, and watch your back'. Not much more than that from a 'world class' authority on human behavior.
When typing my original post, I had thought of signing it, being closer to retirement than many, however just as was the case with some witnesses who declined to testify, some fear lingers nearly 5 years later.