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News Article
NHS Doctors bullied to the brink
Clive Flashman posted a news article in News
The Doctors’ Association UK has compiled stories from 602 frontline doctors which expose a startling culture of bullying and overwork in the NHS. The stories include: a pregnant doctor who fainted after being forced to stand up for 15 hours straight and being denied water. The junior doctor was subsequently shouted at in front of colleagues and patients on regaining consciousness and told it was her choice to be pregnant and that ‘no allowances would be made’. a doctor who told us that a junior doctor hung themselves in a cupboard whilst on shift and was not found for 3 days as no-one had looked for them. His junior doctor colleagues were not allowed to talk about his suicide and it was all ‘hushed up’. a doctor who was denied a change of clothes into scrubs after having a miscarriage at work despite her trousers being soaked in blood. Full press release -
News Article
‘Shameful’ data reveals NHS treatment of minority ethnic staff
Patient Safety Learning posted a news article in News
Five years after launching a plan to improve treatment of black and minority ethnic staff, NHS England data shows their experiences have got worse. Almost a third of black and minority ethnic staff in the health service have been bullied, harassed or abused by their own colleagues in the past year, according to “shameful” new data. Minority ethnic staff in the NHS have reported a worsening experience as employees across four key areas, in a blow to bosses at NHS England, five years after they launched a drive to improve race equality. Critics warned the experiences reported by BME staff raised questions over whether the health service was “institutionally racist” as experts criticised the NHS “tick box” approach and “showy but pointless interventions”. Read full story Source: The Independent, 18 February 2020 -
News Article
Harrowing stories of burned out NHS doctors bullied and broken
Patient Safety Learning posted a news article in News
Dedicated to caring for the sick and vulnerable, junior doctors should expect to be supported and valued as they carry out their vital work. However, hundreds have revealed they are subjected to bullying and harassment at overstretched hospitals that have been plunged into a staffing crisis by a decade of savage health cuts. A Mirror investigation uncovered harrowing stories of young medics being denied drinking water during gruelling shifts, working for 15 hours on their feet non-stop and of uncaring managers tearing into them for breaking down in tears over the deaths of patients. One was even accused of “stealing” surgical scrubs she took to wear after suffering a miscarriage at work. The distraught woman finished her shift wearing blood-soaked trousers, instead of going home to rest. Doctors are now quitting in their droves, leaving those left struggling to cope with a growing workload. The Mirror investigation reveals the reality of working for an NHS which has been subject to a record funding squeeze and is 8,000 medics short. Health chiefs vowed to investigate the Mirror’s evidence from 602 testimonials submitted to the lobbying group Doctors Association UK. Chairman Dr Rinesh Parmar said: “These heartbreaking stories from across the country show the extent of bullying and harassment that frontline doctors face whilst working to care for patients". Read full story Source: The Mirror, 12 February 2020- Posted
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News ArticleOne in three trainee doctors in Australia have experienced or witnessed bullying, harassment or discrimination in the past 12 months, but just a third have reported it. That's according to a national survey of almost 10,000 trainee doctors released today by the Australian Health Practitioner Regulation Agency (AHPRA). The results of the survey, co-developed by the Medical Board of Australia (MBA), send a "loud message" about bullying and harassment to those in the medical profession, said MBA chair Anne Tonkin. "It is incumbent on all of us to heed it," Dr Tonkin said. "We must do this if we are serious about improving the culture of medicine." "Bullying, harassment and discrimination are not good for patient safety, constructive learning or the culture of medicine," Dr Tonkin continued. "We must all redouble our efforts to strengthen professional behaviour and deal effectively with unacceptable behaviour." Read full story Source: ABC News, 10 February 2020
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East of England Ambulance Service staff 'silenced' over bullying
Patient Safety Learning posted a news article in News
Concerns have been raised that NHS ambulance staff are being "silenced" over bullying allegations. Hundreds of East of England Ambulance Service (EEAS) employees reported bullying in 2018, while 28 non-disclosure agreements (NDAs) have been issued since 2016. The GMB union said the figures showed a "heavy-handed culture". The service said it took bullying and harassment "extremely seriously" and had policies to prevent such behaviour. EEAS faced scrutiny in November when it emerged three members of staff died in 11 days. One, Luke Wright, 24, is believed to have taken his own life. An independent investigation, which dealt in part with bullying claims, has been carried out with the results reported to the trust in January. The 28 NDAs had been made in cases where bullying, harassment or abuse by colleagues had been reported, according to figures obtained under the Freedom of Information Act. These involved an individual agreement, often with a payment, which prevented the person speaking about their case. In the latest staff survey from 2018, 23% of staff reported bullying, up from 21% in the previous year. The GMB said NDAs were seen as a "method of silencing rather than resolving" and called on the trust to discuss more meaningful ways of dealing with problems. Read full story Source: BBC News, 10 February 2020- Posted
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News ArticleA whistleblower raised the alarm over patient safety at West Suffolk Hospital because of concerns about the behaviour of a doctor who had been seen injecting himself with drugs, the Guardian has revealed. The incident had already prompted internal complaints from senior staff at West Suffolk hospital, but the whistleblower decided to take matters a step further when the same doctor was later involved in a potentially botched operation. The whistleblower then wrote to relatives of a dead patient and urged them to ask questions about the conduct of the doctor and his background. When they did this, the hospital launched a widely criticised “witch-hunt” in an attempt to find out the identity of the leaker. The doctor’s drug use, which the trust has never acknowledged until now, helps explain why it demanded fingerprint and handwriting samples from staff – tactics which the NHS regulator roundly condemned in a hard-hitting report last week. Read full story Source: Guardian, 5 February 2020
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The Chinese doctor who tried to warn others about coronavirus
Patient Safety Learning posted a news article in News
In early January, authorities in the Chinese city of Wuhan were trying to keep news of a new coronavirus under wraps. When one doctor tried to warn fellow medics about the outbreak, police paid him a visit and told him to stop. A month later he has been hailed as a hero, after he posted his story from a hospital bed. It's a stunning insight into the botched response by local authorities in Wuhan in the early weeks of the coronavirus outbreak. Dr Li was working at the centre of the outbreak in December when he noticed seven cases of a virus that he thought looked like SARS - the virus that led to a global epidemic in 2003. On 30 December he sent a message to fellow doctors in a chat group warning them about the outbreak and advising they wear protective clothing to avoid infection. What Dr Li didn't know then was that the disease that had been discovered was an entirely new coronavirus. Four days later he was summoned to the Public Security Bureau where he was told to sign a letter. In the letter he was accused of "making false comments" that had "severely disturbed the social order". "We solemnly warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice - is that understood?" He was one of eight people who police said were being investigated for "spreading rumours". At the end of January, Dr Li published a copy of the letter on Weibo and explained what had happened. In the meantime, local authorities had apologised to him but that apology came too late. For the first few weeks of January officials in Wuhan were insisting that only those who came into contact with infected animals could catch the virus. No guidance was issued to protect doctors. "A safer public health environment… requires tens of millions of Li Wenliang," said one reader of Dr Li's post. Read full story Source: BBC News, 4 February 2020- Posted
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Top hospital downgraded amid safety fears and whistleblowing inquiry
Patient Safety Learning posted a news article in News
The hospital at the centre of a whistleblowing inquiry has been downgraded by the care watchdog and issued with a warning notice amid concerns over leadership and patient safety. West Suffolk Foundation Trust has been rated requires improvement by the Care Quality Commission (CQC) in a damning report having previously been rated outstanding since 2017. The trust, whose Chief Executive Stephen Dunn received a CBE for services to patient safety in 2018, has faced criticism after bosses threatened senior doctors with a fingerprint and handwriting analysis to try and identify a whistleblower. In a new report published today, the CQC inspectors said they had significant concerns about the safety of mothers and babies in the trust’s maternity unit and the criticised the culture of the trust leadership referencing what they called “threatening” actions. In the West Suffolk hospital maternity unit the CQC found staff had not completed key safety training, did not protect women from domestic abuse, and staff did not always report safety incidents. They also found maternity staff were not taking observations and the unit lacked enough staff with the right qualifications to keep women safe. The trust was issued with a warning notice by the trust demanding it make improvements before the end of this month. On the trust leadership the CQC report said: “The style of executive leadership did not represent or demonstrate an open and empowering culture. There was an evident disconnect between the executive team and several consultant specialities." Read full story Source: The Independent, 30 January 2020- Posted
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News Article
Trust blames behaviour ‘from top of the NHS’ for bullying
Patient Safety Learning posted a news article in News
Leadership behaviour from the “very top of the NHS” has led to an increase in bullying, according to an official strategy document produced by an acute trust. East and North Hertfordshire Trust published its new people and organisation strategy in its January board papers. Within it, the report said: “Leadership behaviour from the very top of the NHS, during this time of pressure has led to an increase in accusations of bullying, harassment and discrimination.” In a separate section, the paper noted the difficulties of being a healthcare professional, saying “many staff leave before they need to and many more cite bullying, over work and stress, as reasons for absence and mistakes”. Read full story (paywalled) Source: HSJ, 13 January 2020- Posted
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News Article
Doctors at West Suffolk hospital 'too scared' to report safety issues
Patient Safety Learning posted a news article in News
Doctors at a hospital accused of bullying its staff have told the NHS care regulator that they are too scared to report lapses in patient safety in case they end up facing disciplinary action. The Guardian revealed earlier this week that West Suffolk hospital stands accused by its own medics of secrecy, bullying and intimidation after it demanded they take fingerprint tests in its effort to identify a whistleblower. Senior staff have privately passed on serious concerns to the Care Quality Commission (CQC) about the behaviour of the trust’s leadership. They used confidential meetings with CQC inspectors, who visited twice in the autumn, to explain why they lack confidence in Steve Dunn, the trust’s chief executive, Dr Nick Jenkins, its medical director, and Sheila Childerhouse, who chairs the hospital’s board. The CQC is due to publish its report into the trust, including the performance of its leadership, in January. “Staff are scared that they’ll face disciplinary action [if they raise concerns about patient safety],” said one doctor, who declined to be named. “As a result of recent events I can’t imagine that anyone at the trust will feel comfortable to speak out or whistleblow in the future. I fear that any future patient safety concerns will not be expressed and will simply be brushed under the carpet.” The trust demanded fingerprints and handwriting samples after a staff member wrote anonymously to the family of Susan Warby, who died in August 2018 after undergoing treatment at the hospital, which was investigated as a “serious incident”. Read full story Source: The Guardian, 11 December 2019- Posted
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Content ArticleIn a previous blog, 'What is a Whistleblower',[1] Hugh drew attention to negative perceptions of whistleblowers in the eyes of some people. A crossword and clues were published on the hub to emphasise how wrong such perceptions are and how damaging they can be, with serious patient safety implications.[2] This follow-up outlines the nature of the journey travelled by some NHS staff who have spoken up and the problems which still exist with NHS whistleblowing culture. It provides a link to an attached file which contains the answers to each clue. The attachment also shows the completed crossword in larger, easier-to-read, format than the small illustration in this blog. There is a further link to companion notes which expand on the answer to each clue. These notes contain more detail about the realities of speaking up. They reinforce the link between hostility towards those who speak up and an ongoing series of patient safety scandals.[7-21]
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Content ArticleIn August 2021, University Hospitals North Midlands Trust (UHNM) commissioned brap and Roger Kline to conduct a review of bullying and harassing behaviours across the Trust. The purpose of the review was to understand: the nature of bullying/harassment within the Trust (what types of behaviour are staff being subject to?) the basis of bullying/harassment (is poor treatment linked to people’s protected characteristics or other aspects of identity (such as language spoken) the scope of bullying behaviour (how frequently are staff subject to bullying behaviours and are they concentrated in particular sites, job roles, or bands? Are staff subject to bullying from patients/visitors or primarily from colleagues?) the response to any unprofessional behaviours (do people feel confident reporting or challenging poor behaviour? If not, why?) the conditions that allow bullying behaviours to continue (what aspects of organisational culture may be contributing to the persistence of bullying? Are stress, workloads, or poor management practice roots causes?) The review was prompted by anecdotal claims of inappropriate behaviour within some parts of the Trust. (The Trust has a range of mechanisms to monitor levels of bullying and harassment, including national and local surveys, reports from the Freedom to Speak Up Guardians, Dignity at Work reports, and staff listening events.) In addition, a survey conducted by BAPIO/LNC raised concerns about the treatment of doctors and how this intersected with issues around race. As such, this review sought to explore whether the treatment of Black and minority ethnic (BME) people was different to that of White British staff.
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Content ArticleThe rapid review was commissioned by NHS England and NHS Improvement, following concerns raised by staff at The Christie Hospital in relation to the Research & Innovation department. The review makes a number of recommendations and the Trust will be developing and action plan to address these.
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Content Article
Crossword counterpoint: glimpses of NHS whistleblowing terrain
Hugh Wilkins posted an article in Whistle blowing
This blog is prompted by a recent newspaper crossword in which one of the clues, quadruplicated, was 'Whistle-blower'. The four answers were, respectively, 'canary', 'snitch', 'telltale' and 'betrayer'. The blog draws attention to negative perceptions of whistleblowers in the eyes of some people. It emphasises how wrong these perceptions are and how damaging this can be, with serious patient safety implications. In this blog I provide a crossword counterpoint (attached below to solve), which seeks to support learning about the realities of hostility against some staff who speak up in the NHS. I will share a follow-up blog which contains the solution to this crossword and seeks to provide further education on this topic where there is so much confusion and misunderstanding.- Posted
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Content ArticleThe West Suffolk Review, commissioned by NHS England on behalf of the Department for Health and Social Care, was published last month. NHSE/I asked the West Suffolk Board to produce an action plan for the 28 January meeting of the Board of Directors. This paper summarises the current position in relation to the learning, reflection and response thus far, including the organisational development actions that have already been taken and require further embedding. It also highlights the engagement undertaken to date, and what more needs to happen, to ensure our plans are based on the priorities for staff, governors, patients and teams and can carry the confidence of stakeholders. The report, 'West Suffolk Review – organisational development plan (p. 217)', sets out nine broad themes of work, linked to the trust’s core functions, “that capture the priority areas for organisational and cultural development at WSFT in light of the learnings from the report”. The document sets out how the trust’s governance, freedom to speak up, HR, staff voice, patient safety and other parts of its corporate infrastructure failed and contributed to a scandal.
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Content Article
'Whistleblowing': a definition for reflection in Speak Up Month
Steve Turner posted an article in Whistle blowing
It's that time again. 'Speak Up Month' in the NHS. In this blog, I discuss the definition of 'whistelblowing' and why this is important. I believe that although the Francis Report has stimulated some positive changes, the only way to successfully move forward on this is to celebrate and promote genuine whistleblowers. This includes using the word 'whistleblowing', not a euphemism. It also needs us to involve everyone, including patients, in the changes. "Whistleblowing isn’t a problem to be solved or managed, it’s an opportunity to learn and improve. The more we move away for labelling and stereotyping the more we will learn. Regardless of our position, role or perceived status, we all need to address this much more openly and explicitly, in a spirit of truth and reconciliation." What is whistleblowing? "In the UK, NHS bodies have been guilty of muddying the waters. Sometimes implying that whistleblowers are people who fail to use the proper channels, or are troublemakers, especially when they go outside their organisation with their concerns. In fact, the Public Interest Disclosure Act makes no distinction between ‘internal’ and ‘external’ whistle-blowers..."- Posted
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Content ArticleSurgery can be a highly demanding environment, and in pressurised situations we need to prioritise patient safety. Under these circumstances there is a need for clear leadership, but being assertive can sometimes be challenging without coming across as aggressive or intimidating. Training is also an area in which potential issues could arise. Not every trainee will develop at the required rate, and it is important to be able to address concerns with an individual without fearing being labelled as a bully. The following recommendations from the Royal College of Surgeons of Edinburgh may help with workplace relationships.
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Content ArticleThe NHS Staff Survey for England reported that almost a quarter of all NHS staff experienced harassment, bullying or abuse from colleagues in the last 12 months. Not only does this have a devastating impact on individuals and the teams within which they work, but it can have dire consequences for patient care. The Royal College of Surgeons of Edinburgh is committed to eradicating bullying and undermining from the surgical and dental professions. It has a number of resources on its website.
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Content ArticleShabazz et al. explore incidents of bullying and undermining among obstetrics and gynaecology consultants in the UK, to add another dimension to previous research and assist in providing a more holistic understanding of the problem in medicine.
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Content ArticleAli Raza uses the Swiss Cheese Model by James Reason to look at discrimination in the workplace.
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Content ArticleThe aim of this study from Björklund et al. was to describe factors that contribute to the occurrence of workplace bullying, that enable it to continue and the coping strategies managers use when they are bullied. They found that several factors could be linked to the bullying: being new in the managerial position; lack of clarity about roles and expectations; taking over a work group with ongoing conflicts; reorganisations. The bullying usually lasted for quite some time. Factors that allowed the bullying to continue were passive bystanders and the bullies receiving support from higher management. The managers in this study adopted a variety of problem-focused and emotion-focused coping strategies. However, in the end most chose to leave the organisation.
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Tackling the blame culture? NHS Staff Survey Results 2020
PatientSafetyLearning Team posted an article in Culture
Patient Safety Learning reflects on the results of the NHS Staff Survey 2020, in relation to its ‘Safety Culture’ theme. The survey indicates that a significant number of staff continue have concerns about whether their organisation takes action to address patient safety issues, and that nearly a third of respondents said that they do not feel they would be treated fairly when raising a concern. This blog considers the patient safety implications of the persistence of blame culture in the NHS and considers the action that can be taken to address this.- Posted
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RCOG/RCM: Undermining toolkit
PatientSafetyLearning Team posted an article in Maternity
The undermining toolkit is an RCOG/Royal College of Midwives (RCM) initiative to address the challenge of undermining and bullying behaviour in maternity and gynaecology services. The toolkit is divided into four sections that can be used independently: Strategic interventions - Recommendations for over-arching institutions such as the wider NHS, GMC, RCOG, RCM and others Unit, trust and local education provider interventions- Recommendations for trusts and hospitals Departmental and team interventions - Recommendations for departments, particularly around team working between obstetricians and midwives Individual interventions - Recommendations for individual victims and perpetrators of undermining. Follow the link below for more information.- Posted
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Content ArticleThis poster was presented by Hugh Wilkins at the UK Imaging and Oncology Congress in June 2019 and highlights the serious problem of retaliation against NHS staff who raise concerns in the public interest.
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