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Found 274 results
  1. News Article
    NHS restructures are exposing deep-rooted inequalities, as valued staff face exclusion, intimidation, and unfair treatment under the name of change says Roger Kline and Joy Warmington in an HSJ article. “The need to do things in a hurry”, we are told, is the system’s way of getting around normal recruitment processes, such as senior appointments in NHS England, trusts and elsewhere – especially the “temporary” ones that become permanent. Across the NHS, we have heard of a significant number of perfectly competent and high-performing staff (especially senior staff) suddenly finding themselves criticised just ahead of the announcement of a restructure. Suspicious? Extremely, especially ahead of restructures where a favoured candidate is earmarked for the role. A significant number of these staff are threatened with being performance managed and subjected to investigations whose only purpose seems to be to demoralise and make voluntary redundancy seem attractive. Nepotism is hardly a stranger to senior NHS appointments, but the scale of planned redundancies and restructure appears to have acted to normalise this poor practice. For example, Alice is a very senior manager with impeccable credentials and appraisals, but finds herself in a restructure in which a close friend of her manager is in direct competition when two jobs become one. Suddenly, she found herself accused of poor performance and is micromanaged and marginalised. She collapsed at work and is off sick. Read full story (paywalled) Source: HSJ, 16 June 2025 .
  2. Content Article
    Workplace incivility and bullying have persisted in healthcare in the USA since increasing during the Covid-19 pandemic.  As the healthcare landscape continues to evolve, so do the challenges teams face, according to Brian Reed, vice president and chief human resources officer for Indianapolis-based Indiana University Health’s east region. This article in Becker's Hospital Review outlines seven strategies to reduce workplace incivility among healthcare teams:
  3. Content Article
    In this podcast interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care. In this episode, emergency medicine doctor Chelcie Jewitt describes why and how she co-founded Surviving in Scrubs, a campaign that shares survivor stories of sexism, harassment and sexual assault in the healthcare workforce. She outlines the work the campaign is doing with professional regulators to set clear behavioural standards that will more effectively hold perpetrators to account. She also describes the training and support that Surviving in Scrubs offers healthcare staff and organisations on how to respond to harassment and abuse. Subscribe to our YouTube podcast to keep up to date with the latest episodes. View a transcript of this interview Read a blog from Peter and Helen about the interview series
  4. News Article
    A hospital trust is involved in a row with the British Medical Association amid concerns over a ’bullying culture’, it has emerged. HSJ has learned of tensions at Doncaster and Bassetlaw Teaching Hospitals Foundation Trust, including an ongoing dispute over a senior medic who has been off work for an extended period. Meanwhile, in recent weeks, the union Unison has launched a survey of the trust’s staff about behaviour, and begun offering staff “don’t bully me” badges, according to flyers claiming there is a “bullying culture”. The union’s organiser Sarah Brummitt said its survey had been launched in response to local reports of bullying concerns. She said: “The survey is open to all staff, and will hopefully give us a better understanding of what issues they are facing, if any.” It follows several concerns raised over the past year about leadership and culture at the trust. The trust says it is “committed to fostering a respectful and inclusive working environment.” Read full story (paywalled) Source: HSJ, 15 May 2025
  5. Content Article
    At the beginning of 2025 we launched our video interview series Speaking up for patient safety. The series is hosted by Peter Duffy, NHS whistleblower and Chair of the Healthcare Working Group at WhistleblowersUK, and Helen Hughes, Patient Safety Learning’s Chief Executive.  In each interview we hear from someone who has raised concerns about patient safety in healthcare, often at great cost to their own career and personal life. They share their story and their reflections on what needs to be done to improve organisational cultures so that when staff raise patient safety issues, their concerns are responded to appropriately and not dismissed because they are inconvenient to address. Alongside the thread of bravery and tenacity that runs through each contributor, a number of common themes come up time and again as people share their experiences. In this blog, Helen and Peter look at some of these themes and outline their implications for people who speak up or whistleblow. We are now three months into the series, which seems like a good time to stop and reflect on what we have learned so far. Our introductory blog about ‘Speaking up for patient safety’ explains why we launched the series and what we hope it will achieve. It also explains in more detail what we mean when we talk about speaking up and whistleblowing. Briefly, speaking up in healthcare is when a member of staff raises concerns about something that is worrying them to a manager or someone else within, or outside of, their organisation. In some cases—but not all—when someone speaks up, it is also defined as ‘whistleblowing’. Whistleblowing always involves a concern that is in the public interest and might relate to a criminal offence, health and safety risks, failures to carry out legal obligations, a miscarriage of justice, or an attempt to conceal and cover up any of these things. Three key themes from the interviews so far These are the top three recurring themes we have noticed coming up in the interviews so far. Other issues we have noticed include the lack of clarity about who should take responsibility for whistleblowing and the reality of threats and bullying, and we will continue to explore these issues going forward. 1. “I didn’t realise I was speaking up, I was just doing my job!” Perhaps the comment we have heard most frequently is that people didn’t realise they were formally speaking up or whistleblowing—they just thought they were doing their job. Every healthcare profession has a set of professional standards which all practitioners are expected to keep to. For example, the General Medical Council (GMC) states that all doctors have a duty to take action by raising concerns if they believe patient care or safety are at risk.[1] In addition, each healthcare organisation has a code of conduct, which will include requirements for staff to be honest, open and accountable for their work. For the interviewees we spoke to, to not raise their concerns would be a failure to fulfil their duty to both their patients and their organisation. When people speak up, they often find themselves in the middle of a process that they had no idea they were entering. This can be very disorientating and leave them unprepared for the path ahead of them. At the end of this blog, we share some advice from our interviewees about what to do if you find yourself in this position. 2. There is a whistleblowing ‘playbook’ Most organisations have policies and support in place to listen to staff members who raise concerns, including access to a Freedom to Speak Up Guardian. We have interviewed Jayne Chidgey-Clark, the National Guardian, who described the good practice that many are developing. However, we are hearing about several common tactics that some organisations use when dealing with people who speak up or blow the whistle. The experiences of our interviewees suggest that these approaches may be deliberately designed to disadvantage the individual throughout the process—from investigation through to employment tribunals. Some of the key activities we have heard about include: Organisations not responding—or responding at the very last minute—to communications from the staff member. Interviewees said they received emails with key information at 5pm on a Friday, which left them with no opportunity to ask questions or respond until the next working week. They expressed their belief that this may be a deliberate tactic to exert pressure on the individual speaking up, which amounts to emotional bullying. The use of occupational health as a way to cast doubt on the mental state of the person. Occupational health providers are often very supportive, but we are concerned that organisations are fishing for reasons to question the believability and motives of staff who speak up. Over-focus on HR issues, rather than focusing on the patient safety issues someone has raised. Mandated isolation from colleagues while investigations take place. This can have a very damaging effect on the person’s mental health as well as restricting their ability to source evidence from other staff in support of the concerns they have raised. We have heard examples of colleagues agreeing to provide supportive testimony, but then feeling pressurised to withdraw this support. Retaliatory referrals against the person speaking up to professional regulators, such as the General Medical Council and Nursing and Midwifery Council, which can have a detrimental effect on a healthcare professional’s reputation and career. Regulators are aware of how such referrals can be used to intimidate whistleblowers and discourage them from raising concerns. Some have approaches to ensure that fitness to practice concerns are appropriately addressed without unfairly impacting doctors who have raised whistleblowing concerns. We believe it is important to identify and call out these tactics so that people raising concerns are aware of them and can seek support and advice. Organisational leaders need to look at their own practice and recognise the ethics of their approaches and whether their actions match their stated organisational values. They need to be aware of the significant damage these tactics cause to people who raise concerns and the chilling impact it might have on their organisational culture, effectively preventing others’ raising concerns. 3. Employment tribunals are unfit, unfair and imbalanced Every person we spoke to who had attempted to pursue justice at an employment tribunal commented that the process was unfit for purpose and not the right place for whistleblowing cases to be heard. Employment tribunals take no interest in the safety issues being raised. The main issue we keep hearing is that the tribunal system is weighted in favour of whichever side has the most financial resources—which will almost always be the employer. A single individual who has lost their employment can rarely succeed against the millions of pounds that organisations are willing to spend on highly specialised lawyers who have tried and tested ways of winning. The playbook we identified above also runs into employment tribunals, with whistleblowers reporting: The employer and their legal advisers withholding key documents, and emails, minutes, notes and other vital information going missing. Key witnesses, often in senior leadership positions, being unable to recall events. Receiving last minute threats from their former employer to come after them for costs and often being given a limited time to consider signing a non-disclosure (NDA) to settle a case. If rejected, often the NHS organisation will seek the full costs from the whistleblower, including expensive external legal costs and internal staff costs, which can amount to thousands of pounds—few whistleblowers can afford to take this financial risk, even if they and their advisers think they have a strong case. Advice from our interviewees if you find yourself speaking up Reflecting on their experiences, our contributors have made some observations about how you can protect yourself when speaking up, should the issue escalate. Try to resolve issues locally first. This is not always possible, but if a concern can be raised and dealt with within a team or with a manager, in some cases this will prevent the situation from escalating to a formal process. Keep a record of concerns and events as they happen. This means you will have some facts and clear observations to refer back to, if the situation does escalate. Don’t go to meetings alone. Take a trusted colleague with you so that every conversation is witnessed. Get your union involved if you are called to meetings about your concerns or receive counter-complaints or accusations. Regulation of NHS managers Some of the interviewees highlighted that regulating NHS managers may be a potential means of tackling some of these issues. The Department of Health and Social Care recently held a public consultation on proposals that could see managers who use misconduct to silence whistleblowers barred from working in the NHS. Patient Safety Learning has formally responded to the consultation, stating that there is a clear case for the regulation of NHS managers, for the protection and benefit of both staff and patients. Everyone in healthcare should be honest and transparent when something goes wrong. Patient Safety Learning’s response expressed support for a professional register of NHS managers and the requirement for individuals in NHS leadership to have a professional duty of candour. These measures would be a positive step in increasing accountability for healthcare organisations in how they respond to staff raising patient safety concerns. But this is only one part of a much wider set of changes needed—significant cultural change also needs to take place in tandem with these reforms. Staff across many organisations are still afraid to speak up, as indicated by the most recent NHS staff survey results. Thank you to our contributors, and an invitation to get involved We’d like to take this opportunity to express our gratitude again to each person who has been willing to share their experiences and insights with us—it can be very difficult to retell traumatic events that have changed the course of your life. We are also aware that there are many other individuals who have experienced unjust treatment because they have spoken up for safety. If that’s you, thank you for your commitment to standing up for safe, ethical care. We invite everyone with experience in this area to contribute to this vital conversation. We would particularly like to hear from: Allied health professionals. Staff from Black and minority ethnic backgrounds Staff in non-clinical roles such as administration. If you would like to share your story, you can: Contribute to our community conversation (you’ll need to sign up first). Comment on any hub post (you’ll need to sign up first). You can find information about organisations that offer support and guidance for staff about speaking up and whistleblowing on the hub. Watch the interviews Helené Donnelly Martyn Pitman Jayne Chidgey-Clark Gordon Caldwell Bernie Rochford Beatrice Fraenkel References General Medical Council. Professional Standards: Raising and acting on concerns about patient safety, 13 December 2024
  6. Content Article
    In this blog, Clare Wade, Patient Safety Learning's Director, draws attention to the impact toxic cultures have on staff and how, sadly, most often nothing is done about it. Clare shares her own personal reflections from past experiences in her career. There is a clear link between toxic cultures and patient safety, and while there are no easy answers these behaviours must be acknowledged, challenged and cured if the NHS is to survive. I’ve personally experienced toxic culture and behaviour on many occasions, but I found two examples particularly tough to navigate. The first was more than 20 years ago when I worked clinically in a trust largely staffed by the local population where most colleagues were either related or friends; I lived some distance away and commuted in. I’d witnessed troubling behaviour from one senior time-served nurse several times, but one day I heard a blatant, serious breach of patient confidentiality between her and another patient. I was shocked and initially didn’t know what to do. I raised it with the nurse involved who laughed at me, and then the sister in charge who told me to just forget it. After much deliberation, I went to the matron in charge of the department. Conversations took place behind closed doors and eventually I was hauled into trust HQ for a formal meeting, alone—the nurse was nowhere in sight. I was accused of causing upset and the nurse had denied any wrongdoing. In no uncertain terms it was made clear that I should keep my head down and mouth closed if I wanted to remain in post. From that day on my time was made miserable, colleagues closed ranks, stopped talking to me and I was ostracised until the day I left the trust. Later in my career, at a different trust, a new director was recruited to lead my department. From the start something felt off as several senior leaders quickly left their roles. It became obvious that the director was a bully; we largely worked in open plan offices, and the director thought nothing of shouting at and belittling people in front of everyone, even other directors and the CEO. It was impossible for senior colleagues not to know what was happening, but no action was taken. The situation worsened with many people taking sick leave or leaving the trust completely. I came under fire as the director didn’t agree with how I led my team or how we worked, even though our performance was excellent. An external consultant was brought in to identify issues with my practice and help build a case against me. The consultant admitted this to me and said they couldn’t find anything wrong to report back. At the time I had a mentor relationship with a senior board member, and I chose to confide in them with the hope of gaining some insight into how I might be able to better deal with the situation. I didn’t know until sometime later, but my mentor was informing the director about our conversations. As time passed, the behaviour worsened and, although many colleagues were experiencing it too, it was obvious I was on my own in wanting to speak up. I was encouraged to go to a senior HR colleague who would be empathetic, so I did and eventually the director agreed to mediation. I was so nervous ahead of the meeting, but it went ahead and to my surprise the director admitted to some of the allegations and agreed some actions. If I thought my treatment had been bad to this point, I had no idea what was to come. It felt like open season with the director’s full toxicity focussed on me. Derogatory rude emails would be sent daily, raising my anxiety as they landed in my inbox. Meetings where we were both present made me feel sick; they would think nothing of singling me out in front of everyone for their derision and nastiness. The barrage was constant and debilitating, affecting every part of my life and breaking my confidence. One day I couldn’t take any more so left work early and crawled into bed at home where I felt safe. I decided to call the senior HR colleague who had facilitated the previous mediation to ask for an update about the agreed actions. I was absolutely shocked to my core at their reaction, they shouted down the phone that I’d had my opportunity to air my grievances, nothing more was going to happen, the director wasn’t going to be held accountable for the agreed actions and I just needed to forget it and get on with my job. Was I naive to expect a different response? I hit rock bottom, felt scared to go into work and knew I had to get out of there for my health and sanity. Even when I left, the impact followed me to my next role; my confidence and resilience were shot and took a long time to rebuild. The director stayed in post for another couple of years until there were so many grievances that the CEO had to act. The sickening part is that after a period of ‘gardening leave’ the director secured another senior role in another trust in the area so will be perpetrating the same toxic behaviour onto others. I know there are thousands of experiences throughout the NHS just like mine and, unfortunately, in many organisations culture and behaviours aren’t improving. This problem is endemic and has decades of history behind it. There is a clear and acknowledged link between toxic cultures and patient safety. Within the NHS Patient Safety Strategy, NHS England states that: "positive patient safety and healthy organisational culture are two sides of the same coin. A culture in which staff are valued, well supported and engaged in their work leads to safe, high-quality care." In order to improve the care delivered to our loved ones, friends and ourselves, the NHS must take action to improve its culture. Forget the financial situation and the waiting lists, this is the most pressing and wicked problem facing our health service today; it permeates throughout everything and unless it is acknowledged, challenged and cured no other interventions will work. Money doesn’t solve toxic cultures, neither does restructuring the NHS for the umpteenth time. Sadly, some colleagues have taken their own lives because of the toxicity they have endured, this needs to stop now. There are no easy answers here but if we don’t put this right the NHS won’t survive. Share your story Have you worked in a toxic culture? Have you tried to speak up? Have you examples of a good team culture? Add your comment below (you will need to be a hub member and signed in) or contact us at [email protected] and we can share your story anonymously. Related reading on the hub Speaking up for patient safety: A new interview series about raising concerns and whistleblowing Speaking up as an agency nurse cost me my career My experience of speaking up as a healthcare assistant in a care home
  7. Content Article
    A frank account from a healthcare assistant on the bullying she experienced after raising concerns at the care home she worked in. I was employed as a healthcare assistant in a care home, where I worked for about three months. During this time, I found out that patient safety and quality of care were undermined by healthcare assistants, and the management and the nurses did not seem to realise it. Examples included: Carers were given a box of gloves each and they were expected to use them for up to two weeks. When asked for more gloves, the manager would check the last time they took a box of gloves and would question what they had done with the last ones they collected. In order to save the gloves, carers used one pair of gloves to deliver personal care to three to five residents before changing them. They would take the rest of the gloves home and bring them back to work in the next shift. Genital care was totally neglected. Residents’ genitals were not cleaned. I spoke to a nurse in another unit about this and all she said was she thought it was being done. When carrying out personal care to one lady, I found dried faeces wrapped in her pubic hair which took me a good number of minutes to clean. When I finally finished doing it, the lady pointed at her private part and said to me “it can breathe now” and when I asked why, she said “because it has been washed”. Infection control. One of the problems was that there was never any soap in the bathrooms and places where there were wash hand basins. So, after personal care, especially after caring for residents who had opened their bowels, we could only wash our hands with clear water. Hand sanitiser dispensers were hanging empty with no sanitising gel, so no opportunity for either visitors or staff to sanitise their hands whilst in the care home. Healthcare assistants apparently had no clue about catheter care, even those working at the nursing unit where there were a few residents that had catheters. I never saw any of them doing catheter care and one day when I was doing it, my colleague was really frightened, held my hand back and said I was going to pull the catheter out. Most of the times when residents opened their bowels, carers would either clean it very shallowly, or they would only take out the soiled pads and replace them with clean ones without cleaning the area at all. As such, when you took over the shift, during the first checks you would think that a resident had opened bowels but find out that the pad was dry and clean at that moment, but the faeces on it and on their skin was dried up. Oral and nail care was another issue. Carers never did oral care, and those who bothered to document would say “resident denied oral care”. Some of the residents’ beds were not functioning, especially in the nursing unit where most of the residents were bed-ridden. This meant that healthcare assistant staff had to bend and strain their backs each time they were giving personal care, which would lead to backaches. After trying to share my concerns on the above issues with three nurses to no avail, I was only left with the choice of talking to the management. I wrote a letter of observation, accompanied by some recommendations. I ended my letter by letting the management know that I was ready to discuss my concerns with them at any time. They did not call me up for any discussion. A change in behaviour... A few days later I started noticing a change of behaviour from all staff towards me. Most of them did not talk to me, many times I found out that people were whispering things about me as when they saw me approaching them they would stop talking. One unit reported that I was very slow, and I was never assigned to work there anymore. People ignored me when I tried to join in a conversation. Each time I was working, nobody would let me do personal care. I was only allowed to work as an assistant to fellow healthcare assistants. In some rooms where I went in first and started doing personal care, they would tell me that I was taking too much time. My opinion on anything did not count. One day when I came to work, there was a small problem which needed to be fixed between one of the nurses and myself, but she refused to listen to me and insisted that I should go back home. I went home as she had asked, and the next day I called and told the manager that I was sent home last night. He started blaming me based on what the nurse had told him, which was not true, without listening to my own side of the story. I insisted that he should call a meeting where he could listen to both of us, because what the nurse had said was untrue. His response to me was that I would need a reference from him so I should be careful about the way I did things. However, he finally accepted and we agreed on a date for the meeting. But when it came to the day of the meeting, the nurse was not there. I explained myself to my manager, in the presence of the secretary. His response to the letter I wrote with my concerns in was that he appreciated it, but he thought that the care home was not the right place for me, and that he thought that I was too qualified for the job. He suggested that everybody felt threatened with my presence. I told him that that it sounded to me like he wanted to remove me from my job; a job which I very much wanted to do. When I came back for the next shift, I discovered that my shift had been cancelled and I had been replaced by someone else. I spoke to a senior carer who called my manager and he told me that he was not expecting me to come to work because of what had happened the other night. I went back home. The next day he called and told me that after due consideration, he had decided to extend my probation time to a further three months, and that I should compose myself, come to work and do only what I was expected to do. Psychologically tortured As I continued working, things got worse each day. I experienced colleagues laughing at me, talking about me, not talking to me, ignoring me; the list could go on and on. I was psychologically tortured. I developed a violent headache. Each time I thought I was going back to work I felt sick, got palpitations, felt so hot as if I had fever, at times shivering, with painful nerves. I kept asking myself whether I was wrong to have done what I did. I did a lot of self-counselling and told myself that I was going to stay at the workplace if I was not dismissed. This was because I was planning to write more letters. I had only highlighted a few of the many issues in my first letter. My hope was that one day someone was going to understand me and things would improve. One night I stopped a colleague from putting a pad on a resident she had not cleaned properly. I cleaned the resident and did vaginal and catheter care, before putting on the pad. There was another resident who was very wet, from their pyjamas to the bedding; my colleague wanted us to only change the pad and let the resident lay with the wet clothes on the wet bed “since they were going to wash her in the morning anyway”. This was the 1am check, and I argued that I could not imagine her being able to fall asleep in that condition. We ended up changing the resident’s pyjamas and putting a towel and an extra pad on the bed to make her feel comfortable. Forced into resigning My colleague became angry with me. I was surprised because I had done nothing wrong. There was altercation and she confronted me. I couldn’t tell anyone as no one would believe me. I felt excluded and alone and the only thing that came to my mind was that I should resign. When I finished work in the morning I went and told my manager that I was resigning. He told me that I was expected to give two weeks’ notice and that I should write my resignation letter that day, which I did. He told me it was rather unfortunate that it hadn’t worked out for me in the care home… Did I do the right thing? What would you do?
  8. News Article
    The former manager of an NHS electroconvulsive therapy clinic has been suspended from nursing after bullying her colleagues. Award-nominated nurse Kara Hannigan is no longer an employee of Cardiff and Vale University Health Board after a regulator found she harassed colleagues, likened the appearance of one to a "prostitute", and created a "degrading" work environment. Hannigan – who was paid more than £53,000 a year as an experienced band seven nurse – qualified in 1991 and became manager of the clinic in 2009. Staff first reported her behaviour in 2015 but after years of inaction by the health board they finally resorted to taking their concerns to the Nursing and Midwifery Council (NMC). Last year a misconduct panel upheld a series of damning allegations against Hannigan and this month it imposed a 12-month suspension. Former colleagues of Ms Hannigan told WalesOnline they welcomed the outcome but that lessons must be learned over the health board's failure to properly deal with the issue a decade ago. They questioned why the health board allowed her to continue working at the ECT clinic – which is based at Llandough hospital and uses electric currents to treat depression – until last November when she was forced by the regulator to start working from home. The misconduct panel found Hannigan's campaign of bullying and harassment occurred between 2014 and 2019. Her behaviour was found to have affected four staff members including two who were subjected to a "hostile" and "intimidating" environment. Hannigan humiliated one nurse in front of other staff by commenting on her appearance as "something like prostitutes would wear" and a "blue mascara girl". In 2015 one nurse told Hannigan the toxic behaviour was making her unwell and that she would be reporting it to a senior nurse in the health board. The next day Hannigan called the victim into her office and informed her she was being placed on a capability process – despite the nurse having a record of strong performance appraisals. The panel found the capability process was bogus and told Hannigan it was "an attempt on your part to deflect from and cover up" the bullying. Panel chairman John Kelly noted Hannigan was so confident in her position that she "felt able to share with another member of staff how she intended to place [the victim] on the capability plan" before the victim had a chance to make a bullying allegation. Read full story Source: Wales Online, 26 March 2025
  9. Content Article
    In this podcast interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care. In this episode, Peter and Helen speak to Bernie Rochford MBE, who spoke up while working as a clinical commissioner at a primary care trust. Bernie found serious issues and inaccuracies in records that posed a risk to patient safety—vital information about Continuing Healthcare patients (patients with significant ongoing care needs in the community) was missing from the system, and there were financial anomalies and serious governance issues. After raising her concerns and getting no response from her managers, Bernie found herself classed as a whistleblower and was isolated at work, eventually losing her job and going to employment tribunal. Bernie describes the serious impact this had on her health and talks about how she is now using her own traumatic experience to work for positive change for others who speak up. She discusses the complexities of regulating managers with Peter and Helen, and argues that we need to look at how people relate, rather than looking to technology, to provide a safer future for healthcare. Now a Principal Freedom to Speak Up Guardian, Bernie currently has a Churchill Fellowship award and is researching different global approaches to speaking up. Subscribe to our YouTube podcast to keep up to date with the latest episodes. View a transcript of this interview Read a blog from Peter and Helen about the interview series Can you help? As part of Bernie’s Churchill Fellowship award she will be looking at speaking up and whistleblowing good practice and alternative approaches from around the world. She will be particularly focusing on approaches in Japan, South Korea, the USA and the Philippines. While her research is predominantly patient safety and healthcare focused, Bernie's interest in learning and sharing best practice goes beyond these areas, as we can learn from other industries and cultures as well. If you have any suggestions, ideas, best practice or experience that you can share with her, from anywhere in the world, please email Bernie. She will be very grateful to hear from you! How whistleblowers are passed around the system In the interview, Bernie talks about how she was passed from one person and organisation to another as she tried to raise her concerns. This diagram, which was included in the report of the Freedom to Speak Up review carried out in 2015 by Sir Robert Francis QC, shows the 54 people, teams and organisations Bernie approached to speak up about the patient safety issues she saw.
  10. News Article
    Surgeons at a top NHS trust were embroiled in allegations of racism, sexism, homophobia and bullying that created a “toxic” culture and harmed patient care, according to a secret report. Consultants responsible for treating thousands of facial trauma patients at Barts Health NHS Trust in London have accused each other of poor surgery, causing avoidable complications and negligence. They say three patients went blind and others needed repair surgery. The surgeons’ relationships have deteriorated since 2017 amid “a constant fight for power and control of the unit”. At least seven patients, who had been waiting for operations for between three and five years, had their procedures cancelled after two doctors refused to work together. The trust admitted that no action had been taken against any of the surgeons and it only informed the Care Quality Commission about the report and its findings on Friday morning, after The Sunday Times made inquiries. The trust said it had found no evidence of patient harm and believed the service was safe. Read full story (paywalled) Source: The Times, 3 February 2025
  11. News Article
    The chair of a foundation trust has resigned after a tribunal found he unfairly forced out its former CEO, because she raised concerns about his bullying behaviour. Susan Gilby was CEO of the Countess of Chester Hospital Trust from 2018 until she was suspended and excluded from the premises in December 2022. The events unfolded at a hugely consequential time for the hospital. Dr Gilby, a former intensive care consultant, joined as medical director in August 2018. But she was made acting CEO shortly after, when her predecessor Tony Chambers was forced to leave, amid a rift with paediatricians and others over the Lucy Letby case. As she approached four years as CEO, the tribunal found Dr Gilby was the subject of a coordinated campaign instigated by chair Ian Haythornthwaite and carried out by chief people officer Nicola Price and two non-executives. The campaign was dubbed “Project Countess” and was “designed to protect the [chair] and manoeuvre [Dr Gilby] out of the trust”. It was launched after Dr Gilby began raising concerns with directors in spring 2022 about Mr Haythornthwaite’s “confrontational and aggressive behaviour”. The tribunal commented on Mr Haythornthwaite becoming angry with junior staff about the refurbishment of the trust offices while the “struggling organisation” faced “an erosion of public faith” in the trust against the backdrop of “a multiple murder inquiry”. This, it said, was “indicative of a chair prioritising his own self-interest above that of the trust and failing to work collaboratively with the CEO and staff”. Mr Haythornwaite joined the trust in 2021. COCH this evening said he had ”taken the decision to step down with immediate effect”. He said in a statement: “I have made this decision in the best interests of the trust so that the focus of the organisation can continue to be on delivering the best possible care to patients.” Read full story (paywalled) Source: HSJ, 14 February 2025
  12. News Article
    A foundation trust CEO was unfairly forced out of her role, after whistle blowing about the bullying behaviour of its chair, a tribunal has ruled. Susan Gilby was CEO of the Countess of Chester Hospital Trust from 2018 until she was suspended and excluded from the premises in December 2022. The events unfolded at a hugely consequential time for the hospital. Dr Gilby, a former intensive care consultant, joined as medical director in August 2018. But she was made acting CEO shortly after, when her predecessor Tony Chambers was forced to leave, amid a rift with paediatricians and others over the Lucy Letby case. As she approached four years as CEO, the tribunal found Dr Gilby was the subject of a coordinated campaign instigated by chair Ian Haythornthwaite and carried out by chief people officer Nicola Price and two non-executives. The campaign was dubbed “Project Countess” and was “designed to protect the [chair] and manoeuvre [Dr Gilby] out of the trust”. It was launched after Dr Gilby began raising concerns with directors in spring 2022 about Mr Haythornthwaite’s “confrontational and aggressive behaviour”. The tribunal commented on Mr Haythornthwaite becoming angry with junior staff about the refurbishment of the trust offices while the “struggling organisation” faced “an erosion of public faith” in the trust against the backdrop of “a multiple murder inquiry”. This, it said, was “indicative of a chair prioritising his own self-interest above that of the trust and failing to work collaboratively with the CEO and staff”. In summer 2022, Dr Gilby raised her concerns directly with Mr Haythornthwaite, who refused suggestions of mediation, and reacted angrily, banging his desk. In September of that year, Dr Gilby “was subjected to concerted, aggressive and unjustified verbal attacks at the private board meeting [which] were not ’shut down’ by the [chair] when he could have and should have done so” according to the tribunal. The tribunal found “on the balance of probabilities” the chair and two NEDs “had agreed before the meeting that [Dr Gilby] would be personally criticised and held accountable for [the trust’s] financial position and steps taken to remedy it”. Read full story (paywalled) Source: HSJ, 14 February 2025
  13. Content Article
    In this interview series, NHS whistleblower Peter Duffy and Patient Safety Learning’s Chief Executive Helen Hughes explore how the healthcare system responds when its staff raise concerns about patient safety. In each episode, Helen and Peter interview someone who has spoken up about patient safety issues in healthcare organisations, or who works to help staff raise concerns where they see unsafe care. In this interview, Peter and Helen speak to Helené Donnelly OBE, who spoke up about unsafe care she witnessed while working as a nurse at Mid Staffordshire NHS Foundation Trust. Helené contributed as a witness to the inquiry led by Sir Robert Francis KC into failings at the trust and was also an advisor in the Freedom to Speak up Review in 2015, where she called for the creation of Freedom to Speak Up Guardians in the NHS. Helené explains why she decided to raise concerns about the quality of nursing care at Stafford Hospital A&E and describes the bullying and threats she received from other staff as a result. She discusses with Peter and Helen the barriers that still prevent staff speaking up today and what can be done to create a more open and responsive culture in teams and organisations. Helené highlights the need to reform how human resources departments respond to staff raising concerns and the vital role of embedding speaking up and organisational culture in the curriculum of all healthcare professional training courses. Subscribe to our YouTube podcast to keep up to date with the latest episodes. View a transcript of this interview Read a blog from Peter and Helen about the interview series
  14. News Article
    Patients who had probes located in the wrong part of their brain due to failings at an NHS trust suffered unnecessarily for years, a damning report has found. The leaked report into deep brain stimulation (DBS) surgery at University Hospitals Birmingham NHS Foundation Trust, seen by the BBC, also shows a whistleblower was ignored, intimidated and disciplined. Wendy Swain, who had electrodes in the wrong place for 11 years, leading to difficulty walking and a facial twitch, said: “They’ve made my life hell.” The trust, already under fire following an inquiry that exposed a culture of bullying and a lack of openness, said it was "truly sorry" for the mistakes and felt "deep regret". Dr Chris Clough, former chair of the National Clinical Advisory Team who oversaw the final report into the brain surgery failings, said he did not believe the trust was learning lessons. “I am begging them to get this report out and be open and fair with patients,” he said. “There’s suffering that has gone on here and they need to let people know what went on.” Read full story Source: BBC News, 6 December 2024
  15. News Article
    An acute trust’s former chief executive was driven out by “manipulative and insidious” bullying by its current chair, she has told a tribunal. Susan Gilby left the Countess of Chester Hospital Foundation Trust at the end of 2022 following a breakdown in relations with chair Ian Haythornthwaite. She is claiming unfair dismissal against the trust and Mr Haythornthwaite, saying she was “bullied, harassed and undermined” by the chair. Dr Gilby joined the Countess initially as medical director in August 2018. This was shortly after its neonatal nurse Lucy Letby, later convicted of murder and attempted murder of babies, had first been arrested, and with investigations ongoing. Dr Gilby was made CEO in 2019, and was in post throughout the peak covid periods, before being suspended in December 2022, and resigning shortly after. According to court documents, issues first arose in late 2021 when a new chair, Mr Haythornthwaite, was appointed. Mr Haythornthwaite made efforts to “assert control through his subtle (and sometimes not so subtle) bullying techniques”, according to Dr Gilby, a former intensive care consultant and medical director. “He would often tell me that ‘people’ (who he refused to name) had ‘said things’ about me, but would refuse to elaborate further,” Dr Gilby wrote in her witness statement. Read full story (paywalled) Source: HSJ, 28 November 2024
  16. News Article
    A teaching trust has been warned it could see resident doctors removed unless it addresses a raft of concerns, including racist and misogynistic behaviour. The General Medical Council has placed conditions on Norfolk and Norwich University Hospital Foundation Trust following a period of “enhanced monitoring”. The concerns cover the trust’s medicine and surgical departments, and involve all grades of resident doctors (formerly known as junior doctors). The trust said it was taking the issues “very seriously” and is “resolved to make this a great place to work, train and develop”. The medical regulator’s director for education and standards Professor Colin Melville said: “Despite ongoing work with the trust for two years, doctors in training in these departments continue to report a range of concerns, including racist and misogynistic behaviours, which need to be addressed as a priority. “There are also concerns around the clinical supervision of doctors in training, handover processes and access to educational opportunities.” The trust was told to adequately cover rotas, and make sure trainees were not subjected to “behaviours including racist and misogynistic behaviours”. Read full story (paywalled) Source: HSJ, 21 November 2024
  17. News Article
    When Sally Mumford enrolled in a training course to become a psychotherapist in 2020, she was excited to start a new career. She hoped to help people understand how their feelings and behaviour were shaped by their pasts. But she quickly realised that the course might not be what she had expected. “I arrived like a lamb to the slaughter,” she said. “There was a real nastiness that percolated down from the top.” Mumford said her tutors at the training centre in London let bullying between students go unchecked. “It was all part of making you into a therapist. The whole ethos was to break you down and build you back up how they wanted you to be.” Mumford is one of more than a dozen people who have studied for psychotherapy qualifications at UK institutions who told the Observer that some courses cross the line from challenging to toxic, with tutors bullying students. Some said their tutors made humiliating remarks to them in public, and left them feeling too scared to speak up or leave the course. But the industry is largely unregulated; “psychotherapist” is not a protected profession, so anyone can set up a practice with that title. Psychotherapist training is also unregulated, and there is a wide range of qualifications across the UK. Amanda Williamson, a psychotherapist who has been campaigning for regulation in the industry for more than a decade, is concerned about “toxic” training courses. “I’ve heard negative feedback about all manner of courses at prominent universities, including appalling tales of bullying and badly-run ‘group process’,” Williamson said. Since psychotherapy training requires students to be vulnerable, she argues, regulations must be more rigorous than in other industries. Therapists and training institutions should be bound by a consistent code of ethics, and regulated by the same body, she said. “Regulation, or at least an inquiry to shine a light on these toxic hotspots that are allowed to fester … is very much overdue.” Read full story Source: The Guardian, 17 November 2024
  18. News Article
    An under-pressure integrated care system has been told it lacks “effective leadership” and is “too centralised and top-down” in a survey of partner organisations. Only 10% of senior leaders said Greater Manchester ICS had the necessary leadership and skills to deliver on its priorities. And only 7% agreed it had “clear roles, effective leadership and efficient processes”, in a survey carried out over the summer. The work commissioned by the ICB received responses from 156 senior leaders in the ICB, its providers, local authorities, place teams, primary care, social care and voluntary and community services in the patch. Several described the system’s leadership as “too centralised and top-down”, with “the tension between centralised control at the GM level and local autonomy” sparking “the most significant numbers of qualitative feedback” to the work, according to an ICB board paper this month. Some also described “bullying by senior leaders and smaller organisations being treated inequitably”. “Recent restructures and upheavals” have “weakened” a “history of great partnership working in Greater Manchester”, the survey feedback summary adds. Read full story (paywalled) Source: HSJ, 29 October 2024
  19. News Article
    A community services provider at the centre of bullying and racism allegations is being formally investigated by NHS England over its governance arrangements, HSJ can reveal. The investigation will look into the governance of Sirona Care and Health, an NHS and council-funded social enterprise which is the main provider of community health services for the Bristol, North Somerset, and South Gloucestershire Integrated Care System. HSJ last month reported that Sirona had launched an internal investigation into its staff culture following allegations of “unacceptable behaviours”, including racism and bullying. In an internal staff message sent this month, seen by HSJ, Sirona interim chief executive Julie Sharma said NHSE “has a duty to make sure our governance is working well” and is therefore “undertaking a formal investigation” into how the provider is run, and its decision-making processes. Ms Sharma said: “We know that some things could be better. For instance, too many of our executive directors are on interim contracts and our board is short of non-executive directors. We are addressing both of these.” Read full story (paywalled) Source: HSJ, 24 October 2024
  20. News Article
    Trainee midwives at a struggling trust have raised serious concerns about bullying and feeling afraid to speak up, an NHS England report has revealed. Experiences of pre-registration midwifery trainees at Birmingham Heartlands Hospital and Good Hope Hospital, part of University Hospitals Birmingham Foundation Trust, are detailed in a recent NHS England workforce, education and training report following a visit in January. The report said learners at BHH reported a “concerning culture of bullying and undermining”, with some midwives displaying hostility and rudeness, and one student constantly feeling like they were in “fight or flight mode”. At GHH, students were aware how to raise concerns but described it as a “waste of time”, telling NHSE qualified midwives had informed them they frequently raised concerns about staffing levels without these being resolved. Meanwhile, at BHH trainees said lack of action taken when they tried to raise concerns had created an environment where learners were reluctant to voice fears about patients or seek guidance on patient care. The NHSE report said students provided multiple instances of trying to raise concerns which were either not acted on or they experienced repercussions for having attempted to speak up. One person expressed concerns about a woman who had experienced severe bleeding following birth but their supervising midwife dismissed their concern. They then escalated the matter to another staff member and was taken more seriously, but as a result, the student said their supervising midwife “made my life hell” for the rest of the shift. NHSE said it heard examples where midwives made derogatory comments about students in public, including about one person’s weight, which caused them to leave the building in tears. Read full story (paywalled) Source: HSJ, 24 May 2024
  21. Community Post
    The West Suffolk Independent Review published yesterday indicates that safety concerns were ignored and the hunt for an anonymous whistleblower was "flawed" and "ill-judged". https://www.england.nhs.uk/east-of-england/wp-content/uploads/sites/47/2021/12/west-suffolk-review-081221.pdf This Review was commissioned following widely reported events arising from an anonymous letter that was sent in October 2018 to the relative of a patient who had died at the West Suffolk NHS Foundation Trust (the Trust). The 225 page report contains important learning and highlights the need for an open culture in the NHS and an end to a culture of avoidance, denial and victimisation of those who speak out for patient safety. This report highlights the need for cultural change and raises several key points: The importance of real and empowered clinical leadership. The importance of NHS leaders being self-questioning, open to criticism and to listen to staff. The importance of leaders understand the value of dissent and disagreement. Where concerns and criticisms appear or do turn out to be misguided, the need for NHS leaders to avoid jumping to any conclusion that the individual raising them is simply making trouble.
  22. Community Post
    As someone who works with NHS and actually as a Mental Health and Physical Health patient I've experienced discrimination and out right assault by the police whilst in hospital and ended up under S136 for no valid reason. Although I was assaulted with handcuffs being thrown over the bed rail, breaking my wrist I think. Still not had my mangled wrist xrayed 2 months on. Nothing worse than being in a vulnerable situation and bullies absolutely thrive on people in vulnerable positions. Their bosses think they're wonderful and so kind but they are in a position of power so of course the bully treats them differently or act differently when seniors are around. I recently put in a formal complaint to CEO I knew very well but instead of replying (after I told her I had recordings) she completely blanked me and now retired. Instead of "this is very serious Dominic, please send any evidence etc" I get told "how wonderful" my bully is! Interim CEO took over so I must inform him of Duty of Candour (Robbies Law) too. They don't seem to like that being pointed out but I shall do it anyway in hope we get a decent CEO who isn't just a pencil pusher waiting for band 9 pension. If as a volunteer I've experienced what I have, I dread to think what goes on as full members of staff. What struck me was the impunity these bullies operate with once in band 8 or above roles. You'd be very shocked if you heard what myself and four other service users went through. At the time my bullies refused to apologise (even though she received "disaplinary action") For me bulling and cronyism are both rotting the NHS from the inside out and needs sorting ASAP Please don't get me wrong, I support 99% of NHS staff but I cannot ignore the bullying, certainly at directorate or managerial level. The small percentage who do bullies seem to have no self awareness and those under them seem to think bullying behaviour is just "Leadership" Well no leader worth any salt will abuse you or tell you who you can and cannot speak too. Seeing service users slowly driven out by a particular bullie was extremely hard and not one manager wanted to know (bar one kind soul). Leadership means you MUST act whenever you even sniff the types of behaviours that signal a bully, however things are that bad that management cannot or won't recognise the controlling and mean behaviours Thanks for reading my first post
  23. Content Article
    Research published in the British Journal of Surgery demonstrates that sexual harassment and sexual assault are commonplace within the surgical workforce and rape happens. This report from the Working Party on Sexual Misconduct in Surgery is a call to action, with a series of recommendations, for healthcare institutions to face up to the shocking reality of sexual misconduct within their organisations.  Further reading: Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign GMC's Good medical practice 2024
  24. Content Article
    Following the Lucy Letby case, letters to the Times discuss workplace rights and safety in hospitals. Keith Conradi, former chief investigator, Healthcare Safety Investigation Branch, highlights a current NHS workforce too frightened to raise safety concerns, working in a toxic and bullying culture, where the predominance of HR approaches undermine the culture of safety. And Andrew Harris, professor of coronial law, William Harvey Research Institute, Queen Marys University London, writes that there is a duty on medical practitioners to report the circumstances of a death and not to limit disclosure to avoid investigation. In his letter he questions whether medical examiners across the country are acting independently of their trusts and properly notifying such cases.
  25. Content Article
    A number of serious concerns were raised about the University Hospitals Birmingham NHS Foundation Trust, relating to patient safety, governance processes and organisational culture. The Trust has been under review by the Birmingham and Solihull Integrated Care Board (ICB), following a junior doctor at the trust, Dr Vaishnavi Kumar, taking her own life in June 2022. In response to these concerns, a series of rapid independently-led reviews have been commissioned at the Trust.  A follow up report into concerns raised about University Hospitals Birmingham NHS Foundation Trust has now been published showing the progress made against the recommendations made in the clinical safety (phase 1) report. It also collates the evidence from phase 2 and 3 of the review and assesses how the lessons learned can at this point be incorporated into the recovery and development plan that the Trust is already progressing. It also takes account of any other concerns that have arisen or been communicated to the review team. The phase 1 review highlighted four areas for improvement: clinical safety governance and leadership staff welfare culture. Appendices 1-4 of the report map the specific recommendations with progress so far. Appendix 1 – Patient Safety Review (Mike Bewick and team – phase 1) recommendations implementation plan: April 2023 Appendix 2 – Summary of the Culture Review by The Value Circle Appendix 3 – Well Led Diagnostic by NHS England Appendix 4 – UHB’s response to the Phase 1 recommendations
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