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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 ArticleAli Raza uses the Swiss Cheese Model by James Reason to look at discrimination in the workplace.
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News Article
Witness at NHS inquiry intimidated by ‘deeply disturbing’ messages
Patient Safety Learning posted a news article in News
A witness to an inquiry into deaths at England’s largest mental health trust has been intimidated by “cruel and calculated pressure”, with messages described by the man leading the investigation as “truly shocking”. In a statement at the start of hearings into the quality of care at Southern Health Foundation Trust, inquiry chairman Nigel Pascoe QC said one witness had received threatening telephone calls, messages and emails, which he said were “totally unacceptable, damaging and deeply disturbing”. Mr Pascoe said the inquiry had been told Beth Ford, whose job title at the trust is service user involvement facilitator, had been intimidated by members of the public. Ms Ford, who has autism, was admitted to hospital for her mental health earlier this month as a result of the abuse, but has now returned home. It’s the latest incident to hit the controversial inquiry, which has itself faced fierce criticism from the families of five patients who died between 2011 and 2015. The families have pulled out of the inquiry and accused the investigation and NHS England of bullying them and going back on promises to properly investigate the deaths of their relatives. Maureen Rickman, whose sister Jo Deering died in 2011, told The Independent she didn’t believe any of the main families were involved in intimidating witnesses. Read full story Source: The Independent, 29 March 2021- Posted
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Content Article
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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Content Article
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 ArticleIn this blog the Safer Healthcare and Biosafety Network and Patient Safety Learning reflect on the results of the NHS Staff Survey 2020, considering how staff safety relates to patient safety in the context of this.
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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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News Article
Southern Health: 'Cultural shift' in communication with patients
Patient Safety Learning posted a news article in News
A doctor told a panel investigating an NHS trust there has been a "cultural shift" in the way staff communicate with patients and their families. Southern Health NHS Foundation Trust is being investigated after failures in its care of five patients who died between 2011 and 2015. Dr Susie Carman said staff went through a "rough patch" when they "felt worried about doing the wrong thing". She said there was "more confidence" among staff to communicate better. The inquiry, which is due to last six weeks, is probing how the trust currently handles complaints, communicates with families of patients, and carries out investigations. It follows a report by Nigel Pascoe QC that found Southern Health, one of the biggest psychiatric trusts in England, acted with "disturbing insensitivity and a serious lack of proper communication" to family members. Dr Carman said there had since been a "genuine culture shift from the top of the organisation". She believed the trust could "still do things better" in its communication methods but said there was "more will about understanding why it (communication) is so important". The inquiry heard that a patient's "consent to share" information or not could present an "obstacle" in communicating with families and carers. Ahead of the inquiry, the bereaved families decided to withdraw from the process after they claimed to have been "misled, misrepresented and bullied" by the NHS. Read full story Source: BBC News, 10 March 2021 -
News Article
Bullying probe at Hancock’s local trust due ‘in spring’
Patient Safety Learning posted a news article in News
A long-delayed review into West Suffolk Foundation Trust board members’ alleged bullying of whistleblowers is now due to be published ‘by the spring’, senior figures familiar with the process have told HSJ. The news comes amid calls from senior medics and a campaign group for the review — originally due for publication in April 2020 — to be published as soon as possible. The review was set up to investigate the “handling and circumstances surrounding concerns raised in a letter that was sent in October 2018, to the relative of a patient who had died in the Suffolk hospital”. The letter was sent to the family of Susan Warby, 57, who died at West Suffolk Hospital in August 2018 after suffering multi-organ failure and other complications. The letter’s anonymous author raised serious concerns about her treatment by the trust. The trust launched an investigation, involving fingerprinting and handwriting experts, to find the letter’s author. The process, led by the trust’s senior management, prompted staff to report they felt harassed and bullied, and unions to label the process a “witch hunt” (See box below: Timeline of West Suffolk bullying allegations). NHS England and Improvement is overseeing the probe, which was ordered by ministers in January 2020. The coronavirus pandemic caused publication to be pushed back until December, but no official reasons have been given for the further delay. Read full story (paywalled) Source: 9 March 2021- Posted
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News Article
GPs’ survey finds race discrimination in NHS treatment of primary care
Patient Safety Learning posted a news article in News
A survey of an area’s GPs and other primary care staff found those from a minority ethnic background feel they are less involved in decision making and less respected by their colleagues, according to results shared with HSJ. The survey, instigated by GPs in Doncaster, South Yorkshire, also found more staff from a minority ethnic background said they had experienced some form of bullying or harassment, including “instances of physical violence”. The work is thought to be unusual in primary care — annual “workforce race equality standard” surveys are required by NHS England for NHS trusts and, in the past year, clinical commissioning groups, but not in primary care. The survey in October was instigated by Doncaster Primary Care BAME Network and facilitated by Doncaster clinical commissioning group. It was sent to GPs and practice staff, community pharmacy staff, and other “healthcare professionals” in primary care. There were 136 respondents. The report of the results said minority ethnic staff felt they were less able to make decisions to improve the work of primary care, less involved in decisions regarding their area of work and less respected by their colleagues compared with their white colleagues. Read full story (paywalled) Source: HSJ, 9 March 2021- Posted
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News ArticleA children’s nurse who raised legitimate concerns over racial discrimination at a major London trust was suspended and victimised by her managers for doing so, an employment tribunal has ruled. Jeyran Panahian-Jand, who worked on a children’s ward at Whipps Cross Hospital, parts of Barts Health Trust, had raised concerns with her manager in 2019 that staff were divided on “racial lines”, with an “unfair allocation of work”, as well as bullying of two junior staff. Her manager Heather Roberts, as well as other superiors, told Ms Panahian-Jand she should raise a formal complaint, without offering to look at the issues raised and keep the complaint informal, which the tribunal said they should have done under whistleblowing policies. Ms Roberts later accused Ms Panahian-Jand, who identified as white, of continuing to talk about her allegations on the ward, and with the agreement of Ghislaine Stephenson, the associate director of nursing for children, Ms Panahian-Jand was suspended for the “disruption” and “upset” she was causing, the tribunal judgment said. Ms Panahnian-Jand then lodged a formal complaint over race discrimination, as well as accusing two other bank nurses of making “racially abusive” remarks. A subsequent internal investigation supported three allegations of race discrimination made by Ms Panahian-Jand, while a separate probe into her own alleged misconduct found there was no case to answer. Read full story (paywalled) Source: HSJ, 23 February 2021
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Content ArticleJeremy Hunt asks the Secretary of State for Health and Social Care, Helen Whately, what proportion of NHS staff have experienced bullying and harassment in the workplace in each year from 2010 to 2020.
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News Article
Bullying on NHS maternity units and poor training a risk to safety, MPs told
Patient Safety Learning posted a news article in News
Doctors and midwives working in maternity services face higher levels of bullying than any other part of the NHS, MPs have been told. According to the General Medical Council, trainee doctors in maternity services report more than twice the level of bullying seen in the rest of the NHS while the Nursing and Midwifery Council said midwives were also more likely to be bullied. MPs on the Commons health select committee heard that the culture in some maternity units was a major barrier to improving safety and tackling poor care. In an evidence session as part of an ongoing inquiry into maternity care, MPs were also warned the lack of properly funded training was forcing some midwives to pay out of their own pocket. The inquiry by the committee was launched last year after repeated maternity scandals at the Shrewsbury and Telford Hospitals Trust and East Kent Hospitals University Trust. Giving evidence to the committee, Charlie Massey, chief executive of the General Medical Council said: “We do see in our data some quite troubling data around bullying." “If you are an obstetrics or gynaecology trainee, we see in our national training survey each year that some 14% report that they have experienced bullying – and that’s against an average for all trainees of 6%. You see more than double the rate of bullying in obstetrics and gynaecology than you do elsewhere.” Read full story Source: The Independent, 20 January 2021- Posted
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News ArticleA nurse who was threatened by colleagues for speaking out about care failings at Mid Staffordshire Foundation Trust has said bullying remains a “real problem” in the NHS. Helene Donnelly has told MPs that more than 10 years on from the scandal – commonly known as Mid Staffs – she was still seeing “echoes” of what she experienced happening across the country. “Although it is in the minority, as we saw at Mid Staffs the results can be absolutely catastrophic” She called for the development of a national body to improve workplace cultures in the NHS and “stamp out bullying once and for all”. The inquiry into poor standards of care and deaths at Mid Staffordshire indentified issues around staff behaviour, inadequate staffing levels and skills, and lack of effective leadership and support. Ms Donnelly told a Health and Social Care Committee hearing today that there were “real negative behaviours” at the trust that created a “real bullying culture of fear and intimidation”. “There was not a culture that encouraged and enabled staff to speak up and if they did as I did, we were bullied and threatened,” said Ms Donnelly, who now holds the roles of ambassador for cultural change and lead Freedom to Speak Up Guardian at the organisation where she works. Read full story (paywalled) Source: The Nursing Times
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News Article
NHS urged to publish delayed report on hospital 'witch-hunt'
Patient Safety Learning posted a news article in News
The NHS is under pressure to publish a delayed review into a bullying scandal at Matt Hancock’s local hospital that involved senior clinicians being asked to provide fingerprint samples in a “witch-hunt” for a whistleblower. The “rapid review” into West Suffolk hospital, which Hancock had to recuse himself from because of his friendship with the boss at the trust, was ordered in January and had been due for completion in April. Its publication was put back to this month because of the coronavirus pandemic. But it is now not expected until spring. The Doctors’ Association UK suspects the conclusions are being sat on because they make embarrassing reading for the trust’s chief executive, Steve Dunn, described by Hanock as a “brilliant leader”. A consultant who chairs the hospital’s medical staff committee wrote to the NHS’s regional director for the east of England, Ann Radmore, last week warning that senior medics felt the hospital could not move on until the review was published. The NHS East insists the review will be published as soon as possible, but a source confirmed this is likely to be “spring next year”.- Posted
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Content Article
BMJ: Speaking up against bullying in the patient community
Claire Cox posted an article in Bullying and fear
Many of us are aware of school campaigns against bullying, protecting school aged children from harmful experiences that pose life-long lasting effects. Phrases such as “don’t be a bystander” and “stand up” are used to remind us of our obligation to help those who need it. Yet, these efforts rarely continue into our adult lives, and have mainly ignored the devastating effects of bullying on people from all walks of life, including in the patient community. -
News ArticleA review of a clinical commissioning group has discovered “microaggressions and insensitivities” towards Black, Asian and minority ethnic staff, and the use of derogatory slurs about other groups. The report into Surrey Heartlands CCG also uncovered incidents of shouting, screaming and bullying among other inappropriate behaviour. And it was reported some staff were unwilling to accept Black Lives Matter events as important, stating “all lives matter”. The review also discovered a culture of denial and turning a blind eye to consistent concerns, with staff fearful of speaking up. In particular, the HR department was said to have been repeatedly told about the behaviour of one staff member but had chosen to ignore or delay dealing with the issues. However, the review found “no evidence for widespread discriminatory practices” and “no clear evidence for a widespread culture of bullying and ill-treatment” — but it added the systems to deal with concerns had failed and there was a sense of “organisational inaction”. Read full story (paywalled) Source: HSJ, 27 November 2020
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News ArticleThe staff-side committee of a major hospital trust has stopped working with its leadership, with its chair alleging an ‘endemic’ culture of ‘racism, discrimination and bullying’. Irene Pilia, staff-side committee chair at King’s College Hospital Foundation Trust, told colleagues that the decision was taken “in the interests of staff”, especially black, Asian and minority ethnic workers, and expressed concerns about the organisation’s disciplinary procedures. She said the decision had the backing of staff committee officers and delegates. Ms Pilia, who is also the senior KCHFT Unite representative, said she was open to resuming partnership working again, but told trust executives: “I have lost trust and confidence in the ability of [KCHFT] to conduct fair, impartial and no-blame investigations. “Until there is tangible and credible evidence that racist behaviour at all levels is proactively eliminated, such that perpetrators face real consequences (including to the detriment of their careers) for their actions and are no longer allowed to behave in racist ways with impunity, I take a stand for the hundreds, possibly thousands of KCHFT staff whose voices are not being heard." Read full story (paywalled) Source: HSJ, 22 October 2020
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News ArticleAn independent review found that commissioners’ investigation of a young boy’s death was ‘mismanaged’, and heard allegations that the person who coordinated it was bullied over the contents. The independent review, commissioned by NHS England, has published its final report following an investigation into Bristol, North Somerset and South Gloucestershire clinical commissioning group’s LeDer review into the death of Oliver McGowan. Chaired by Fiona Ritchie, the independent review was commissioned last year after evidence emerged that the CCG had rewritten earlier findings of the review, removing suggestions his death at North Bristol Trust in 2016 was avoidable. Oliver died in November 2016 after being given anti-psychotic medication against his own and his parents’ wishes and despite medical records showing he had an intolerance to anti-psychotics. He developed severe brain swelling because of the drugs and died.A local LeDer review — part of a programme aimed at improving care based on deaths among people with learning disabilities — was launched in 2017, seven months after his death, by the CCG (then operating as three separate organisations), then published in 2018. In 2018, a coroner concluded Oliver’s care prior to his death was “appropriate” and made no recommendations. His death is also currently the subject of a police investigation. The lead reviewer (Ms A) stated in her panel interview that during the time she was undertaking this LeDeR she had felt bullied, overworked and overly stressed by the demands placed on her by the various correspondences with solicitors and her line management. The fact that Ms A believed she was isolated and unsupported during this review illustrates evident failures in the CCG assurance and management processes at the time. In a final report by the subsequent independent review, published today, the panel led by Ms Ritchie “unanimously” agreed Oliver’s death was “potentially avoidable”. Read full story (paywalled) Source HSJ, 20 October 2020
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Community Post
Is the word 'Whistleblowing' taboo?
Steve Turner posted a topic in Speak Up Guardians
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It's #SpeakUpMonth in the #NHS so why isn't the National Guardian Office using the word whistleblowing? After all it was the Francis Review into whistleblowing that led to the recommendation for Speak Up Guardians. I believe that if we don't talk about it openly and use the word 'WHISTLEBLOWING' we will be unable to learn and change. Whistleblowing isn’t a problem to be solved or managed, it’s an opportunity to learn and improve. So many genuine healthcare whistleblowers seem to be excluded from contributing to the debate, and yes not all those who claim to be whistleblowers are genuine. The more we move away for labelling and stereotyping, and look at what's happening from all angles, 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 with a genuine desire to learn and change.- Posted
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News ArticleAn ambulance service could be put in special measures after a damning report criticised poor leadership for fostering bullying and not acting decisively on allegations of predatory sexual behaviour towards patients. East of England Ambulance Service Trust failed to protect patients and staff from sexual abuse, inappropriate behaviour and harassment, the Care Quality Commission said. It failed to support the mental health and wellbeing of staff, with high levels of bullying and harassment. Staff who raised concerns were not treated with respect and some senior leaders adopted a “combative and defensive approach” which stopped staff speaking out. “The leadership, governance and culture still did not support delivery of high-quality care,” the CQC said. Read full story (paywalled) Source: HSJ, 30 September 2020
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News ArticleNHS leaders are being encouraged to have ‘difficult discussions’ about inequalities, after a trust found its BAME staff reported being ‘systematically… bullied and harassed’, along with other signs of discrimination. A report published by Newcastle Hospitals Foundation Trust found the trust’s black, Asian and minority ethnic staff are more likely than white staff to be bullied or harassed by colleagues, less likely to reach top jobs, and experience higher rates of discrimination from managers. It claims to be the first in-depth review into pay gaps and career progression among BAME workforce at a single trust. The new report revealed that, in a trust survey carried out last year, some BAME staff described being subjected to verbal abuse and racial slurs by colleagues; had left departments after being given no chance of progression; and been “systematically… bullied and harassed”. Read full story (paywalled) Source: HSJ, 22 September 2020
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News ArticleA hospital boss championed by Matt Hancock has been told to end “a toxic management culture” after doctors were asked to provide fingerprint samples to identify a whistleblower. The Royal College of Anaesthetists (RCoA) has urged the chief executive of West Suffolk hospital, Steve Dunn, who Hancock described as an “outstanding leader”, to take urgent action to improve the wellbeing of senior clinicians and “thereby the safety of patients”. In a strongly worded letter sent to Dunn in July, seen by the Guardian, the RCoA president, Prof Ravi Mahajan, reminded him that “undermining and bullying behaviour is unacceptable”. Following a three-day review of the hospital, Prof Mahajan’s letter said senior anaesthetists had complained about a “toxic management culture that risks impairing their ability to care safely for patients”. The incident, and other failings in patient safety, contributed to the hospital becoming the first ever to be relegated by Care Quality Commission (CQC) inspectors from “outstanding” to “requires improvement” in January. A spokesman for the trust said: “Ensuring our colleagues work in a supportive, safe environment is good for our staff and means better patient care, which is why we have done extensive work this year to act on feedback about our working culture, including taking action to address the concerns raised by the Royal College of Anaesthetists.” Read full story Source: The Guardian, 11 September 2020
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News ArticleA nurse in the US sued Louisville, Ky.-based Kindred Healthcare this week, alleging the organisation fired him in retaliation for raising patient safety concerns. Sean Kinnie worked as an intensive care unit nurse at Kindred Hospital-San Antonio. Mr Kinnie claims he was suspended twice and then fired after leaders at the 59-bed transitional care hospital learned he anonymously reported patient safety concerns to The Joint Commission in November 2019 and January. Mr Kinnie said issues related to inadequate staffing and unsanitary care environments put patients in "grave danger," according to the lawsuit. He also said the hospital created a culture in which employees were afraid to stand up for patients for fear of retaliation from management. In January, Mr Kinnie told the hospital's chief clinical officer Sharon Danieliewicz that he was the staff member who reported the patient safety concerns to The Joint Commission. Mr. Kinnie claims he faced increased scrutiny after this disclosure and was ultimately fired Feb. 24 for violating facility policy. Read full story Source: Becker's Hospital Review, 24 August 2020
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