By Simon Wilson, senior solicitor and medical negligence expert at Neil Hudgell Solicitors
A report published this week illustrates how bullying in the NHS can have a direct impact on the standard of care received by patients and ultimately, in my view, to the costs to the organisation of dealing with complaints.
The report by the Care Quality Commission into the Barts NHS Trust in London describes the overall quality of care provided by the Trust. One of the findings is that morale across the Trust is low with “a perception of a closed culture and bullying”.
The report goes on: “Too many members of staff across all levels and all sites came to us to express their concerns about being bullied. Many only agreed to speak with us if they could be anonymous. In the 2013 staff survey 32% of staff reported being bullied; the average score for trusts in England was 24%.”
As these statistics demonstrate and, from my own experience, the situation in Barts Trust is not unique but mirrored elsewhere: staff feel disconnected from their trust’s Executive and feel undervalued and not supported. The culture is often not sufficiently open and some staff feel inhibited in raising concerns. Morale is often low across all staffing levels and some staff feel bullied.
In this type of environment it’s inevitable that the standard of care received by patients will be affected. Staff who fear speaking up may hide clinical mistakes, be reluctant to be a “whistle blower” or find it simplest not handle patient queries openly and honestly. All this helps to perpetuate mistakes within the NHS and reduces the opportunities to admit and learn from past errors and to improve.
In addition, poor care and treatment of patients has a knock on effect on the number of complaints made. If these complaints are not handled well or, if appropriate, an apology offered by the clinicians involved, the likelihood increases of a patient resorting to legal action. This in turn leads aggrieved patients to pursue claims for compensation from the NHS, many of which end up on the Trust’s boardroom table.
To stop this cycle, a culture of openness and learning has to be fostered in the NHS, but it has to start from top. Managers need to set an example, to stop bullying practices and encourage honesty and candour in all staff. In short, cut out the bullying in the NHS and everyone benefits – from board to ward.