Let's banish bullying from the NHS once and for all
Thu 25 Aug 2016
MiP is leading a national initiative to tackle bullying and harassment, which undermines managers’ work and damages their careers. Jon Restell explains how the programme is shaping up.
MiP is at the heart of a piece of partnership working which aims to reduce the persistently high levels of bullying in the NHS. More than a fifth of staff have reported bullying by managers or colleagues in recent NHS staff surveys, and more than 40% say they have witnessed it.
We know that a culture of disrespect harms staff wellbeing and, as the Carter Review recently emphasised again, can severely impair organisational effectiveness. But the fact that bullying also damages patient care is less often discussed.
International research shows that disruptive and disrespectful behaviour by healthcare professionals leads to an unsafe culture – distraction from clinical work, errors, withdrawal, burnout, reputational damage and more people leaving. Staff are less likely to admit mistakes, raise concerns or work effectively in teams – with obvious implications for patient care and safety.
On the initiative of health minister Ben Gummer, the NHS Social Partnership Forum (SPF) is planning a new campaign to tackle bullying in the NHS. I am leading this work as co-chair of the SPF’s Workforce Issues Group (WIG). We have already staged a workshop facilitated by NHS Employers in November, a ministerial roundtable in February and, most recently, an interactive session at the NHS Confederation in Manchester.
Madeline Carter of Newcastle University is helping NHS unions and employers to work with the available data. Her own research and evaluation of other evidence suggests the NHS should take a broad-ranging, strategic approach, with interventions targeted at different levels.
At the organisational level we need to concentrate on:
- a positive work climate
- conduct codes policy
- recruitment and selection
- formal investigations
- job design
At the team level we should focus on:
- conflict management training
- multisource feedback
- bystander action
And at the individual level we are targeting:
- well-designed, relevant training
- coaching and mentoring
- informal support
- therapeutic approaches and counselling
In the past, we’ve tended to create a framework of policies and training within which individuals can challenge bullying. These are still important but insufficient without organisational interventions by employers and a positive work culture. As we argued in a blog post for the NHS Confederation, “there needs to be recognition that bullying is an organisational issue, not just a conflict between individuals”.
Partnership working can deliver where top-down diktat has failed, because we can make a much stronger call to action. Small groups of policy wonks working at speed won’t deliver as effectively as an inclusive, long-running conversation involving people from all over the system.
A key principle of the campaign is that NHS organisations should decide on their own ambitions. Rather than setting another target from the top, the campaign will support organisations to deliver their ambitions with best practice and monitoring tools.
Boards and union representatives in NHS organisations will soon be asked to pledge to foster a learning culture and to commit to build a workplace where staff are trusted and supported, where bullying and harassment are tackled, positive behaviours role-modelled, and staff are supported to challenge negative behaviour.
The SPF agrees that leadership, accountability and measurement are the key ingredients for success. Leadership is particularly critical. Research shows that leaders affect culture by role-modelling, rewarding, condoning, ignoring and punishing certain behaviours. Two of the biggest barriers to reporting bullying are the belief that nothing would change and that leaders would not take any action.
Our campaign is a work in progress and still faces several hurdles, not least persuading system leaders – the DH, system managers, commissioners, regulators, professional bodies and trade unions – that building a culture of respect is an issue for them as well as for organisations, teams and individuals. We must also link our campaign to other work on discrimination and productivity.
I’m very positive about the work so far and pleased that MiP has made a big contribution to tackling an issue that affects a growing number of our members, both as employees and managers.
If you are experiencing bullying or harassment at work, contact your MiP national officer or local Link Member as soon as possible. If you would like to contribute to MiP’s work on tackling bullying and harassment, drop us a line to firstname.lastname@example.org.
Infographic: NHS Employers. Download the full infographic