When the damning findings of the Mid-Staffs inquiry were published more than a decade ago, there were many public pronouncements insisting ‘never again’.
The scandal led to the landmark report by Sir Robert Francis which called for compassion, an end to the culture of fear in the NHS and, in its place, an environment in which doctors and other healthcare professionals felt safe and able to speak out.
Sir Robert’s report also led to the creation of the National Guardian’s Office and the advent of staff working to support doctors in the form of freedom to speak up guardians.
In March this year, however, the first of a series of three reports by Professor Mike Bewick into workplace culture at UHB (University Hospitals Birmingham) found the behaviour of the trust’s management towards its staff had created a culture of fear.
Responding at the time of the publication of the first report, the BMA workforce lead Latifa Patel voiced the association’s deep concern with conditions at UHB warning that ‘bullying, poor management and a culture hostile to internal and external criticism have made UHB a horrific place to work for NHS staff’.
With further reports still to come, the issue of workplace bullying in the NHS and the damaging effect it has on staff wellbeing and, by extension, on the standard of care provided to patients, was subject to passionate debate at this year’s BMA annual representative meeting in Liverpool on 3 July.
Warning that a ‘corrosive culture’ of bullying still exists within parts of the NHS, the ARM heard how bullying and harassment adversely affect staff and the patients they deliver care to and should have no place in the NHS.
The meeting further called on NHS organisations to embrace openness and candour, take fundamental attitudinal change to management and for NHS managers found responsible for bullying and harassment to be held to account.
‘The Bewick report highlights the devastating implications for bullying, cronyism, and a deep-rooted toxic culture within the NHS,’ Samuel Parker (pictured above), a GP in the north-east, told the conference.
‘Sadly, bullying and harassment are something many health care professionals have experienced and persists despite multiple serious incidents.
‘Bullying reduces morale, increases sickness and staff absences, drives dedicated clinicians out of the NHS and ultimately reduces patient care. The public expects safe healthcare, but this requires appropriate staffing and a safe working environment.’
Change of management
Dr Parker said the findings from the investigation into UHB had exposed the ugly reality that, despite all the lessons of the past, some of those working in NHS management were minded to prioritise corporate reputation over investigating ‘serious patient safety concerns’ raised by doctors and other staff.
‘A Freedom of Information Act request revealed UHB referred 26 of its doctors to the GMC in the last year,’ Dr Parker told the ARM.
‘In all cases the GMC took no action. This is beyond shameful and questions the decision making and competence of the referrers. Such behaviours are abhorrent and have no place in the NHS.’
‘The NHS crisis will only worsen until there are wholesale changes in NHS management, and it acquires the leaders it needs and deserves. Managers must be accountable to the same standards as staff.’
Exeter medical student Naabil Khan told the conference that workplace bullying had no place in the health service and urged doctors to show their support for this principle by backing the motion.
She said: ‘It is essential we have reaffirmed this principle. Every member of our healthcare workforce, from doctors to nurses to administrative staff and support workers deserve a safe and respectful environment.
‘Fundamental changes need to be enacted to ensure we can all work together without fear, intimidation and prejudice.
‘One of the pillars of the NHS is to stand together for patients. Let's make sure this is honoured by eradicating bullying and harassment in the workplace.’