Here, she explains that workplace bullying and undermining in the NHS are so widespread, only long-term collective action can hope to eradicate it.
Bullying and undermining are unfortunate realities for many working in the NHS. The 2018 NHS staff survey again showed just how endemic the problem is, with around a quarter of everyone working in the NHS reporting they had been bullied, harassed or abused by their managers or colleagues over the past twelve months.
However, one problem is that a lot of people working in the NHS don’t even realise that they’re being bullied – they think inappropriate comments, little digs at people or corridor conversations are just what happens in the healthcare environment.
It’s very easy to dismiss such behaviours as mere ‘banter’ or the over-reactions of ‘snowflakes’. In fact, they create an unsupportive culture that at the very least has a pernicious affect on those on the receiving end or at their very worse, endanger the patients we are here to serve.
Studies in the US for instance have attributed disruptive behaviour in the perioperative area alone (before, during and following surgery) to 67% of adverse events, 71% of medical errors, and 27% of perioperative deaths. This is unacceptable.
Nonetheless, the size and scale of the problem as well as an increasing appreciation of the personal and system wide impacts that bullying and undermining have, has led to a number of initiatives designed to address this issue.
In our case, the Royal College of Surgeons of Edinburgh has made it a permanent priority. We have developed a series of professional standards we expect our 26,000 members and fellows to adhere to.
We have also created a freely accessible online toolkit and e-learning module available to anyone in the profession, regardless of where they are in their career, location or College affiliation. This is because bullying can affect everyone. In addition, we are lobbying for improvements to be made to both the working environment and the training pathway.
And there is similar impactful work being done by the Social Partnership Forum, Patient Guardians, Royal College of Nursing, British Medical Association and Royal College of Obstetricians and Gynaecologists amongst many others. Indeed, credit must be given to the General Medical Council for developing a new training programme on professional behaviours and patient safety in collaboration with a range of partners.
However, change will only occur if interventions are coordinated and conducted over the long term. Last year, organisations from across the medical and healthcare professions came together to form an anti-bullying alliance, which aims to give individuals and organisations affected by this problem, more information on the range of support available to them.
Yesterday (4 Apr 2019) we launched a reference document [PDF], which brings together this information, and we plan to send this to decision makers and influencers within hospitals, and medical stakeholders. Because unless chief executives, HR, managers, and medical directors are actively involved, our initiatives aren’t going to work.
We hope that this launch will lead to further initiatives and interventions. Bullying in the NHS is caused by a complicated mix of service pressures, poor leadership and outdated cultures and behaviours. Too often we find that the onus is on the individual to either deal with situations themselves or to raise concerns and challenge behaviours.
This must end.
We need each NHS organisation at every level having an honest, open discussion about the levels of bullying in their organisation, drilling down to understand where, and why, it is happening.
People need to constantly think about their behaviour and the impact it has. Where appropriate, we also need to hold bullies to account and rigorously evaluate what interventions works well and why.
I hope this is the next step in this long journey.