Report lifts the lid on bullying and harassment at troubled NHS board
● Damning findings after whistleblower revealed A&E waiting times were being falsely recorded at Lothian hospitals
“We heard several examples of when staff were left ‘in tears’ by the behaviour of others, including from those relatively new in post”
THE ACADEMY OF MEDICAL ROYAL COLLEGES
NHS Lothian has a culture of bullying and harassment, failed to accurately record breaches of a waiting time target and does not always properly prioritise patient safety, a report has found.
The Academy of Medical Royal Colleges carried out the review after a whistleblower raised concerns in October about doctoring of patients’ waiting times to meet the four- hour target to process A&E patients.
Its publication yesterday coincided with Shona Robison’s resignation as health secretary following a catalogue of problems, including missed targets and a financial scandal at NHS Tayside.
The report on NHS Lothian looked at the emergency departments at St John’s in Livingston, Edinburgh Royal Infirmary and the Western General.
It said staff at all levels felt there was “limited focus” on emergency care from the board.
On St John’s, it said: “We found evidence of bullying and harassment of some individuals and observed styles inconsistent with good working relationships with several staff who were openly distressed. Medical leadership felt almost non-existent and, at best, disjointed.
“We heard several examples of when staff were left ‘in tears’ by the behaviour of others, including from those relatively new in post.”
At the infirmary, the report said medical leadership was “fragmented”. “Some staff felt they were treated badly and unsupported when raising concerns and stated they would be wary about doing so again. Consultants described feeling disengaged from the senior management team.”
The culture at the Western General was “more positive”. But the report said: “Concern was expressed about the future of WGH, with a feeling that the WGH site is less important than the other sites.”
NHS Lothian had carried out its own internal report on under-reporting of A&E waiting times, which said staff acted with the best of intentions in developing local guidance on recording waits because national guidance was vague and ambiguous.
It said staff were under “intense pressure” beyond that of working in a busy department, but said none of those interviewed felt bullied or harassed.
But the independent report said the national guidelines were clear and it disagreed with the finding on bullying.
The report comes six years after former NHS Lothian chief executive Professor James Barbour abruptly retired after evidence of waiting time manipulation surfaced. A report at the time on bullying within NHS Lothian described an “undermining, intimidating, demeaning, threatening and hostile working environment”.
Yesterday’s report said: “NHS Lothian has had a previous review into its culture and, despite action being taken, we felt that this had not yet been fully embedded at all levels of the organisation.”
In its recommendations, the report said: “The issue of bullying and harassment requires urgent action.”
It urged NHS Lothian to “develop a more transparent culture that enables staff at all levels to report concerns without fear of repercussions”.
And it said: “A review of the leadership requirements on all three sites should be undertaken aimed at strengthening the overall general and clinical management.”
Lothian ms pa nd tory health spokesman Miles Briggs said he would be seeking an urgent meeting with NHS Lothian to discuss how the recommendations would be implemented.
He said: “This is a truly damning report into the culture of NHS Lothian, which found a total lack of robust management, with staff often afraid to raise concerns for fear of reprisals. That must change and never be able to occur again.
“Bullying and harassment are completely unacceptable anywhere and especially so in an environment where patients’ lives are at stake. It is now vital that we see a genuine change in the culture at NHS Lothian, not just warm words.”
Jim Crombie, interim chief executive of NHS Lothian, said: “We have recognised from the outset that mistakes were made and accept the findings of this review. It’s clear not all was as it should have been. Staff have also come under intense pressure and for these failings I’m really sorry.
“We also share the Scottish Academy’s concern about bullying behaviour. In the face of intense and sustained pressure, working relationships can sometimes be fraught and plainly we have not been doing enough.”