‘A culture of bullying’ exposed at city’s hospitals
CQC REPORT REVEALS SOME CASES INVOLVED RACIAL DISCRIMINATION WARNING ISSUED OVER TRUST’S LEADERSHIP AND RISK MANAGEMENT OVERALL RATING LOWERED FROM ‘GOOD’ TO ‘REQUIRES IMPROVEMENT’
A NUMBER of failings have been outlined in a damning report on Nottingham hospitals published today.
Problems with leadership and a “culture of bullying” – including cases of racial discrimination – were among problems identified by the Care Quality Commission (CQC) following its latest inspection of Nottingham University Hospitals (NUH).
As a result of its findings from the inspection carried out across June and July, the healthcare watchdog has lowered its rating of the NHS trust which runs the Queen’s Medical Centre and City Hospital from “Good” to “Requires Improvement”.
NUH bosses were issued with a warning, ordering them to make improvements around leadership, risk management, governance and culture.
Inspectors said they were told in two separate forums of bullying incidents across NUH and highlighted a failure to address a “culture of bullying across the organisation”.
They added they were told there was a “lack of ability to address or resolve incidents in a timely fashion and that culture, policies and procedures did not provide staff with adequate support”.
The report also says they were told of a number of bullying cases that were “directly attributable to racial discrimination”, and that according to a staff survey the trust was above average for black, Asian and minority ethnic staff experiencing bullying or harassment.
Problems were also identified with the relationship between the board and the wider organisation, as well as safety and safeguarding incidents.
Inspectors said that there was “not always a culture of highquality, sustainable care”.
“We found the culture to be top-down and directive,” says the report. “It was not one of fairness, openness, transparency, honesty, challenge and candour. There was a disconnect between the board and the wider organisation.
“We were told there was separation between the board and the divisions and this was the worst it had been in many years.”
The report says that corporate and clinical governance were not working together to effectively oversee risks and drive health improvements.
It states: “Executive leaders did not appear to recognise how the two were linked. As a result, there was a lack of communication and respect between the two systems inside the organisation.”
It revealed they were told at the end of June there was a backlog of 3,858 open patient safety incidents and that “there had been no risk stratification of these as yet to understand any risk”.
NUH, which has received 201 negligence claims over maternity care over the past decade, resulting in more than £91m paid out in damages – was also criticised for shortfalls in relation to maternity.
“Oversight of the maternity services and the management of performance issues had not been sufficiently robust to allow known issues to be addressed,” the report continues.
QMC’S urgent and emergency services were also told to improve.
Sarah Dunnett, CQC’S head of hospital inspection, said: “There was a high level of anxiety among staff in the emergency department about the overall lack of capacity and space to meet the needs of people.”
Inspectors did say, however, that they saw examples of good practice across the trust, with both hospitals’ surgery services receiving a “good” rating.
“Surgery services at both sites were managed effectively with high quality patient care deemed a priority,” said Ms Dunnett. “Staff were caring, supportive and respectful and worked hard to achieve the best outcomes for patients.”
A spokesperson for the Nottingham branch of Keep Our NHS Public (KONP) said that the report shows the NUH have “serious management issues”.
“The public experience of the NHS is through the doctors, nurses, porters and other support staff who care for them and it is essential that these people are listened to,” they said.
“We hope this report will be a wake-up call to senior officers and the board.”
Visitors to the hospital expressed their surprise at the findings of the report.
“I’m shocked to hear there are concerns on how it’s run,” said one anonymous patient. “I certainly have never experienced any issues here.”
Natalie Davis, 35, from Long Eaton, added: “I think it’s always been run well, I don’t personally think there’s been anything wrong. But then again I’m not here often enough to notice anything.”
Rupert Egginton, deputy chief executive and chief financial officer at NUH NHS Trust, said: “We would like to assure patients and colleagues that we are working hard to address the serious concerns highlighted in the recent CQC report, focusing on standards of leadership within the Trust.
“It’s important to note that the report does not criticise clinical services and recognises the care, dignity, compassion and kindness that our staff provide for our patients; but it’s our job as the leaders of the Trust to ensure that the foundations of our organisation - our processes, governance, and learning from incidents improve to allow our teams to provide safe, high quality care within a positive, open and supportive culture.”