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Found 199 results
  1. Content Article
    What happens if a surgeon accidentally drops an instrument on the floor, picks it up and reuses, without it going through a steriliser? Should this be allowed to happen? Well it did! 
  2. News Article
    Managers at a hospital where police are investigating dozens of deaths promoted a consultant surgeon months after they allegedly assaulted junior doctors during surgery, the Guardian can reveal. Two female registrars at the University Hospitals Sussex NHS trust in Brighton sent written statements to the trust’s chief medical officer in March 2022 detailing how they were allegedly assaulted by the surgeon in separate incidents as they helped to operate on patients, leaked documents reveal. The incidents were not reported to the police and are not part of a separate Sussex police investigation into allegations of medical negligence and cover-up at the trust’s surgery and neurosurgery departments, involving at least 40 deaths and more than 60 incidents of patient harm. The consultant surgeon was alleged to have slapped one of the registrars across her face with the back of a hand. The other registrar claimed she was slapped on the hand and had surgical instruments snatched from her by the same person. The trust said its investigation found the surgeon’s actions were inappropriate but did not constitute assault and were taken in the interest of patient safety. The surgeon apologised to the registrars. The investigation concluded that, in the first incident, the registrar’s visor was blocking the consultant’s field of vision during surgery, causing them to instinctively push the visor away. In the second incident, it concluded that an instrument was taken from the registrar’s hand during a procedure for patient safety purposes. After these events, other registrars threatened to refuse to go into theatre with the consultant and pointed to other alleged examples of their bullying, sources claim. They had expected the consultant to be disciplined, given time off work and supported in changing their behaviour, the sources added. Instead, within a year of the complaints, the consultant was given a leadership role in the surgery department, despite the trust’s stated policy of zero tolerance for violence and aggression. Read full story Source: The Guardian, 22 April 2024
  3. News Article
    Nearly a dozen junior doctors have been relocated from a London hospital’s general surgery department by NHS England, after concerns about a culture of fear, poor support, and reports of bullying. NHSE has withdrawn 11 surgical foundation year trainees from Barnet Hospital, in north London, after a review uncovered concerns regarding staff behaviour and safety. The General Medical Council has opened a case into the hospital’s department, which is run by the Royal Free London Foundation Trust, and the trainees have been placed elsewhere in the trust. Colin Melville, the GMC’s medical director and director of education and standards, told HSJ: “Doctors in training in the department reported a culture of fear, worry, and feeling unsupported and unable to raise concerns in the appropriate manner. “There are also concerns over their supervision, bullying, and undermining behaviours in the department, as well as doctors’ physical and mental wellbeing. “Because of the [trust’s] failure to meet the high standards we require, we stand firmly with NHSE workforce, training, and education London’s decision to relocate the 11 trainees, [to] where they can work and learn in a supportive environment. “This action is necessary not only to ensure their safety, but to protect the public as well.” Read full story (paywalled) Source: HSJ, 18 April 2024
  4. Content Article
    In this Guardian interview, Rob Behrens, the outgoing NHS Ombudsman for England, says that too much unsafe care is still happening in the health service and that a culture of cover up makes it hard for bereaved families to find out the truth about their loved one's death. He describes the NHS as a complex institution run by mostly excellent, committed staff that is beset by cultural issues and a focus on limiting reputational damage at the expense of transparency and fair treatment of staff who speak up.
  5. Content Article
    The NHS will always need whistleblowers as healthcare is complex, rapidly changing and dangerous. However, whistleblowers continue to be treated very poorly by the health service, as this Private Eye special report highlights. The report looks in detail at several whistleblowing cases and how attempts to cover up mistakes and wrongdoing have resulted in patient deaths and devastated the careers and personal lives of staff who speak up for patient safety.
  6. Content Article
    This report aims to understand the NHS response to racism, what trusts and healthcare organisations do about it and how effective they are at addressing it. It brings together key learning from a number of significant tribunal cases and responses from 1,327 people to a survey about their experiences of raising allegations of racism within their organisations.
  7. News Article
    Bosses at hospitals where police are investigating dozens of deaths have been criticised for “bullying” and fostering a “culture of fear” among staff in a damning review by the Royal College of Surgeons in England. The review focused on concerns about patient safety and dysfunctional working practices in the general surgery departments at the Royal Sussex County hospital in Brighton and the Princess Royal hospital in nearby Haywards Heath. But the reviewers were so alarmed by reports of harassment, intimidation and mistreatment of whistleblowers that they suggested executives at the University Hospitals Sussex trust may have to be replaced. They concluded: “Consideration should be given to the suitability, professionalism and effectiveness of the current executive leadership team, given the concerning reports of bullying.” The report comes as Sussex police continue to investigate allegations of medical negligence and cover-up in the general surgery department and neurosurgery department, involving more than 100 patients, including at least 40 deaths, from 2015 to 2021. The investigation was prompted by concerns from a general surgeon, Krishna Singh, and a neurosurgeon, Mansoor Foroughi, who lost their jobs at the trust after blowing the whistle over patient safety. Read full story Source: The Guardian, 6 February 2024
  8. Content Article
    This report sets out the findings of an Independent Review into the care and treatment provided by Greater Manchester Mental Health NHS Foundation Trust. The review was commissioned following reports of failings within the Trust’s services at the Edenfield Centre and the failure within the organisation to escalate concerns and mitigate patient harm.
  9. Content Article
    "Our #health system in the UK is in a mess. It has failed to modernise (by this I mean to become fully accountable to #patients and the public, and truly patient-led). Instead, the system has become more and more hierarchical, bureaucratic and crony ridden, mostly as a result of constant meddling and pointless reorganisations instigated by politicians. All political parties in government for the past 30 years have had a hand in this decline." This is my view? What is yours? A new Inquiry gives us all an opportunity to have our say. I am proud to have worked in and for the NHS for most of my working life; proud to have been trained in the #NHS and proud of the work being carried out by clinical teams today. Great work which has benefited patients, often not because of the leadership but despite of the leadership. I'm retired so I can say what I like. If I were working and said anything even vaguely like criticism, however constructive it was, I would be out of a job and my career would be blighted for life. I'm speaking from experience here, unfortunately. I urge everyone to respond to the consultation (link below). In your response think forensically and write it as a statement of truth. Acknowledge the successes and areas that have delivered safe and effective services. If you are being critical give examples and say if it is an opinion or back up what you say with evidence. If we work together across boundaries we can develop a truly patient-led NHS.
  10. News Article
    NHS Highland will no longer receive extra government support in leadership, governance or culture, following improvements after the Sturrock review. The board was initially escalated to Stage 3 of NHS performance escalation framework in 2018 following concerns of a culture of workforce bullying and harassment. An independent report by John Sturrock QC, commissioned by the Scottish government, confirmed “fear, intimidation and inappropriate behaviour” and called for wide-ranging changes. The Healing Process was created in response, with an independent review panel established to speak to victims of bullying and come up with recommendations for the health board to make improvements. A total of 272 current and former NHS Highland and local health and social care partnership staff provided testimony between 2019 and March this year, with more than £2.8m paid out to those affected by bullying. Concerns were raised by some of the first people to go through the healing process that the system was “broken” and many victims could end up “bitterly disappointed”. The board has also established systems and processes to allow colleagues to speak up in the wake of the Sturrock Review, including an independent Guardian Service and staff training in Courageous Conversations. NHS Highland was handed oversight of its own escalation and de-escalation, rather than a Scottish government-led oversight group, in November 2021. Following a letter of assurance from the board chair earlier this year, the Chief Executive of NHS Scotland, Caroline Lamb, agreed to the de-escalation in September. Independent progress tracking shows the board has delivered significantly against many actions laid out by the review but the board concluded in its final June update that ‘culture change is not yet embedded at all levels of our organisation’. Read full story Source: Health and Care Scotland, 2023
  11. Content Article
    Professor Jane Somerville, emeritus professor of cardiology at Imperial College, talks about the issues facing doctors who raise concerns about patient safety issues in the NHS. She shares her views on the risks facing doctors who speak up and the ways that healthcare managers treat whistle blowers. She also highlights issues in the employment tribunal system and outlines the need to regulate NHS managers. In the video, Jane mentions the employment tribunal of Dr Martyn Pitman. Since this interview was recorded, Dr Pitman lost the case he brought for retaliatory victimisation.
  12. Content Article
    Surviving in Scrubs have published their first report 'Surviving healthcare: Sexism and sexual violence in the healthcare workforce' is now live. The report is an analysis of 150 survivor stories submitted to their website since they launched in 2022. It details the findings on the incidents, factors and challenges unique to healthcare that permit sexism and sexual violence in the healthcare workforce. The report contains recommendations to healthcare organisations to better support survivors and end these behaviours.
  13. Content Article
    A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. Leape et al. identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behaviour in the health care setting: disruptive behaviour; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behaviour; passive disrespect; dismissive treatment of patients; and systemic disrespect. At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognised by health workers as disrespectful. Disrespect is a threat to patient safety because it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices. Nurses and students are particularly at risk, but disrespectful treatment is also devastating for patients. Disrespect underlies the tensions and dissatisfactions that diminish joy and fulfilment in work for all health care workers and contributes to turnover of highly qualified staff. Disrespectful behaviour is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behaviour is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.
  14. Content Article
    Nurse bullying has been an issue for decades and continued during the Covid-19 pandemic. Now, in the post-pandemic era, allegations of toxic behaviour are continuing to climb.  Becker's spoke with Jennifer Woods, vice president and chief nursing officer at Baptist Health Hardin in Elizabethtown, Pennsylvania, and Jamie Payne, chief human resources officer at Saint Francis Health System in Tulsa, Oklahoma, to understand the increase in nurse bullying and how their health systems are working to address it. 
  15. Content Article
    In this opinion piece for the BMJ, Rammya Mathew talks about the limits of a no blame culture in identifying where harm is being caused by a clinician. "The Letby case is an extreme example of the shortcomings of a “no blame” culture. When things go wrong we’re encouraged to always support staff and ensure that no one feels implicated. It’s as though only systems and processes can be criticised, and discussing the possibility of individual accountability is considered “off grounds.”
  16. News Article
    More than half of staff at a hospital trust that has been under fire for its "toxic culture" have said they felt bullied or harassed. The findings come from an independent review commissioned by University Hospitals Birmingham (UHB) NHS Trust. It has been at the centre of NHS scrutiny after a culture of fear was uncovered in a BBC Newsnight investigation. UHB has apologised for "unacceptable behaviours". It added it was committed to changing the working environment. Of 2,884 respondents to a staff survey, 53% said they had felt bullied or harassed at work, while only 16% believed their concerns would be taken up by their employer. Many said they were fearful to complain "as they believed it could worsen the situation," the review team found. Read full story Source: BBC News, 27 September 2023
  17. Content Article
    The Culture Review report was published following an independent external review of the organisational culture at University Hospitals Birmingham Trust. The external review was carried out by consultancy firm The Value Circle following a series of investigations into problems at University Hospitals Birmingham Foundation Trust over the last year.
  18. News Article
    A whistleblower who worked at a hospital trust where hundreds of babies died or were left brain-damaged says there was "a climate of fear" among staff who tried to report concerns. Bernie Bentick was a consultant obstetrician at the Shrewsbury and Telford NHS Trust for almost 30 years. "In Shrewsbury and Telford there was a climate of fear where staff felt unable to speak up because of risk of victimisation," Mr Bentick said. "Clearly, when a baby or a mother dies, it's extremely traumatic for everybody concerned. "Sadly, the mechanisms for trying to prevent recurrence weren't sufficient for a number of factors. "Resources and the institutionalised bullying and blame culture was a large part of that." More than 1,800 cases of potentially avoidable harm have been reviewed by the inquiry. Most occurred between 2000 and 2019. Mr Bentick worked at the Trust until 2020. He said from 2009 onwards, he was raising concerns with managers. "I believe there were significant issues which promoted risk because of principally understaffing and the culture," he said. He also accuses hospital bosses of prioritising activity - the number of patients seen and procedures performed - over patient safety. "I believe that the senior management were mostly concerned with activity rather than safety - and until safety is on a par with clinical activity, I don’t see how the situation is going to be resolved," he said. Read full story Source: Sky News, 27 March 2022
  19. News Article
    Fresh concerns have been raised about the treatment of whistleblowers by managers at a trust recently embroiled in a high-profile bullying scandal, the hospital’s workforce director has disclosed. A series of further accusations have been made against managers at West Suffolk Foundation Trust, where executives were recently judged to have led an “intimidating, flawed” hunt for a whistleblower, prompting a series of high-profile departures. The trust’s executive director for workforce detailed in a paper for the hospital’s July board meeting how managers had been hunting to identify staff who had raised concerns through supposedly confidential channels. The report, by executive director of workforce and communications, Jeremy Over, said: “Feedback has been given indicating that some people have had a poor experience when speaking up. “In two separate cases, where people spoke up in confidence, it was reported that the managers were then asking and wishing to find out who had spoken up making the individuals very uncomfortable. “Another case reported that the individual was ‘told off’ by their manager for ‘going about their heads’ [sic] and another where staff felt discouraged from raising any points or suggestions as these were taken [as] a personal offence [by] the senior staff. In a further case, the person speaking up was criticised [for] doing so.” Read full story (paywalled) Source: HSJ, 3 August 2022
  20. News Article
    The patient lay slumped next to a pile of pills and a personally signed note reading: 'do not resuscitate me'. His breathing was agonal, his skin mottled, his pupils fixed, no pulse discernible. The attending doctor, in agreement with both paramedics and family member, decided to respect his wishes. Yet, this GP was placed under investigation for gross negligence manslaughter by the Crown Prosecution Service (CPS) for not resuscitating the patient, setting in motion a sequence of investigations, including by the coroner and the General Medical Council (GMC), that were triggered by the statement of one policeman at the scene. All investigations and allegations were eventually dismissed but not until the GP had been through years of significant physical and mental stress. Still today, questions remain unanswered – in particular, concerning the actions of the police and the CPS. Speaking under the condition of anonymity, the GP spoke to Medscape News UK, and said that now, over 7 years after that fateful home visit, she remained resolute that she made the correct clinical decisions at the time. "It has all been very stressful for me. What was behind this case? What was driving this potential prosecution? And throughout, the patient, the family and their concerns were completely forgotten in the pursuit of so-called justice," she pointed out. Read full story Source: Medscape News, 9 March 2023
  21. News Article
    NHS Ambulance service have a “fear of speaking up” amid pervasive “cliquey”, sexist, racist and homophobic cultures, a watchdog has warned. A national guardian has warned of negative cultures in trusts preventing workers from raising concerns as she called for a “cultural review” of ambulance organisations. The review into whistleblower concerns, by the Freedom to Speak Up Guardian’s office, has found widespread cultural issues including clique-like behaviour and bullying and harassment. Dr Jayne Chidgey-Clark, the NHS National Freedom to Speak Up Guardian, has now called on ministers and the NHS to independently review ambulance services, after speaking with ambulance staff across five NHS trusts. The report has called for a cultural review of the ambulance service by NHS England, the Care Quality Commission, the Association of Ambulance Chief Executives and ministers. Read full story Source: The Independent, 24 February 2023
  22. News Article
    A health minister has called for more staff to take part in an inquiry into deaths at a mental health trust. An independent review into 1,500 deaths at the Essex Partnership University Trust (EPUT) over a 21-year period was launched in 2020. It emerged earlier this month that 11 out of 14,000 staff members had come forward to give evidence to an independent inquiry. The trust said it was encouraging staff to take part in the inquiry. During a parliamentary debate, Health Minister Neil O'Brien said the trust was being given a "last chance" before the government intervened and instigated a statutory inquiry. A statutory inquiry would allow staff to be compelled to give evidence. In December, a further 500 deaths were made known to the review chair, Dr Geraldine Strathdee. She said the inquiry could not continue without full legal powers. Chelmsford MP Vicky Ford said she had been told by the chief executive of EPUT that staff were "very scared" to give evidence. Read full story Source: BBC News, 31 January 2023
  23. News Article
    A top doctor has blamed a "dysfunctional" culture at NHS Highland for a crisis in medical recruitment and retention engulfing its rural hospitals. Dr Gordon Caldwell, a consultant physician who was the clinical lead at Lorn and Islands hospital in Oban until he resigned last summer, said there "still seems to be a lot of fear" among staff more than four years on from a bullying scandal that cost the health board nearly £3 million in settlements. Dr Caldwell - who joined NHS Highland in 2018 - said an exodus of senior consultants from Oban and Fort William over the past 18 months is down to management "undermining us, bullying us, and blaming us for problems that were due to a lack of leadership". The 66-year-old, who is internationally regarded for his expertise in medical education, became so concerned about the impact on junior doctor training in Oban that he whistleblew to NHS Education for Scotland (NES) while on sick leave for stress after finding his own internal complaints rebuffed. A resulting inspection report, published in May last year, said NES had "serious concerns about the training environment" at Lorn and Islands hospital, including around the "safety of care". Read full story Source: The Herald, 1 April 2023
  24. News Article
    Repeated cases of bullying and a toxic environment at one of England's largest NHS trusts have been found in a review. The Bewick report was ordered after a BBC Newsnight investigation heard from staff at University Hospitals Birmingham (UHB) saying a climate of fear had put patients at risk. A first phase of the rapid review, headed by independent consultants IQ4U and led by Prof Mike Bewick, was published Tuesday. It is one of three major reviews into the trust, commissioned following a series of reports by Newsnight and BBC West Midlands in which current and former staff raised concerns. Summarising the findings, Prof Bewick, a former NHS England deputy medical director, said: "Our overall view is that the trust is a safe place to receive care. "But any continuance of a culture that is corrosively affecting morale and in particular threatens long-term staff recruitment and retention will put at risk the care of patients across the organisation - particularly in the current nationwide NHS staffing crisis. "Because these concerns cover such a wide range of issues, from management organisation through to leadership and confidence, we believe there is much more work to be done in the next phases of review to assist the trust on its journey to recovery." The West Midlands trust said it fully accepted the report's recommendations. Read full story Source: BBC News, 28 March 2023
  25. News Article
    Two external reviews have been carried out into a trust’s general surgery services amid concerns about whether it is a ‘safe interpersonal working environment’. But University Hospitals Sussex Foundation Trust has refused to make the reviews – which were both completed last year – public, partly because of what it says are concerns that they could lead to “harassment” of doctors who spoke to the authors. Both reviews were into aspects of the general surgery services at the Royal Sussex County Hospitals in Brighton. The trust has had a series of highly critical Care Quality Commission reports into some of its surgical services and a “well led” report is expected to be released in the next few weeks. The trust has refused HSJ’s Freedom of Information Act request to release the reviews, arguing that those interviewed had been promised confidentiality, and the issues involved are “emotive and sensitive matters”. “Disclosure could cause those involved in the reviews damage, distress and upset and could even lead to harassment,” it said. Read full story Source: HSJ, 27 March 2023
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