NHS staff lay bare a bullying culture

Bullying is a pernicious problem in the NHS. That’s the stark finding from exclusive research by the Guardian. The online survey of more than 1,500 doctors, nurses and other health workers in hospitals, primary care and community settings, found that 81% had experienced bullying and for almost half of them (44%), it is still ongoing. Close to nine out of 10 bullying victims who responded have been left with their cases unresolved.

Although the survey on bullying was self-selecting, the findings underline the results of the official annual NHS staff survey. The 2015 survey of nearly 300,000 healthcare professionals across England found that a quarter of staff in NHS trusts had experienced bullying, harassment or abuse in the previous 12 months.

Some 87% of respondents to the Guardian survey, carried out between August and September, think bullying is a big problem within the NHS, while almost three-quarters said they felt the health service did not take bullying seriously. “The culture is driven by exerting undue pressure on others to get things done. If you don’t, you are targeted and eventually you end up with stress and depression,” one NHS manager said.

“The organisation becomes defensive and takes the corporate line to protect themselves from a legal challenge and puts it down to your perception. You are then managed out of your job through contrived actions designed to make you leave. All this leaves you broken and with no strength to fight. You go if you can find another job. Otherwise you suffer in silence.”

The devastating impact of bullying is all too apparent. A third of victims said they had been pushed out of their jobs, with many developing serious mental health problems as a result, while almost three-quarters reported increased stress and panic attacks. As a result, some 41% said they needed counselling or treatment after being bullied. The survey also shows the adverse impact of bullying on the NHS, with those respondents who have been bullied taking on average 108 days off work and almost a third (31%) saying they were signed-off sick. A further third said they had contemplated leaving their job.

Sue Covill, director of development and employment at NHS Employers, (the employers’ organisation for the NHS in England) admits the results are worrying. “Bullying is completely unacceptable and the ongoing work to tackle it is vital for all NHS organisations, leaders and staff,” she says. “To improve the working lives of our staff and deliver the best possible care to patients, we need to create supportive, positive, open and collegiate cultures in our organisations across the health system.”

According to the 1,355 anonymous survey respondents who said they had experienced or witnessed NHS bullying, the most common forms of abuse are undermining behaviour and persistent criticism. Just over a third said they were persecuted through fear or threats, saying their career was deliberately sabotaged. One in 10 bullying victims was subjected to violent behaviour and aggression.

Asked if a particular incident triggered the bullying, 55% said raising a concern prompted the abuse. Fear of reprisals means that only 54% reported the bullying. For the 43% who chose not to report it, two-thirds felt scared that to do so would make things worse. Of those who did report their bullying, 44% said it persisted afterwards, sometimes for as long as a year.

“My experience left me feeling as though I had been manipulated, that I was a liar and had made it all up,” said one NHS administrator. “I had a meeting with my bully and came away from it feeling worse than before. I’m now left feeling desperately unhappy in a job I now despise.”

Only 17% of those who reported bullying said they received pastoral support from their organisation – and less than a quarter of these were satisfied with the result.

A YouGov survey commissioned last year by the TUC showed that nearly a third of people had been bullied at work.

Concerns have been raised by health professionals and academics that the hierarchial structure of the NHS facilitates a culture where bullying can flourish.

“Medicine is a hard taskmaster but made worse by those around you who see you as a threat that rocks the hierarchy where everyone should know their place,” an anonymous hospital consultant says in response to the results of the Guardian survey. He warns: “It may well impact on patient care if those who perpetuate the abuse look for an opportunity to trip you up and blow any minor omission out of all proportion.”

Dr Anthea Mowat, chair of the British Medical Association’s representative body, says the survey results should act as an urgent wake-up call to employers. “If more staff are to speak out, they must be able to raise concerns without fear of being harassed or victimised, and there need to be clear and supportive systems of reporting in place,” she says. “We need to put an end to the climate of fear that has built up in the NHS over a number of years, with those in senior positions in the NHS leading by example to make this a reality.”

The survey, by the Guardian’s Healthcare Professionals Network, was sent out to network members via an email newsletter. It was also promoted via Twitter and Facebook. Network readers were also invited to take part through the website.

Nurse who left the NHS: the loss of my role was like a bereavement

I was an experienced nurse working in a fantastic team of staff. Following a reshuffle, our ward manager was replaced by someone who was known for being a bully. She frequently made comments and used language inappropriate for the role. Her victimisation of me began immediately. On one occasion, due to staff sickness I was expected to do the jobs of four other people and was reprimanded when I objected. I was expected to attend meetings on my days off. I was constantly ridiculed and told that medical staff had criticised me even though, when questioned, they quite clearly had not. On one occasion I was physically pushed out of the way. This went on for over a year and, along with the treatment of me that followed, had a devastating effect on my psychological health. I was having panic attacks and suicidal thoughts.

I took out a grievance and was immediately moved to an area where I had no previous experience or expertise. Unable to continue working I was signed off sick with work-related stress. My bullying complaint was not investigated properly and not upheld. I believed that I had been targeted as I had previously raised concerns about patient care. I appealed against the decision and with the support of a union representative and witnesses, I won. But the bully remained in post and I was offered a job in another area, at a lower grade. I was advised by my union that I was being constructively dismissed and not to return to work. I negotiated an exit strategy with payment of a tax-free lump sum under one of the now-outlawed compromise agreements. I am now in receipt of an NHS permanent injury benefit which guarantees me a tax-free income, in excess of what I was previously earning, for the rest of my natural life. I now work for a private company in a non-clinical setting. The loss of my clinical role has been like a bereavement and not a day goes by when I do not think about the injustice of my case.

NHS manager: the bullies have wrecked my career

There is an endemic culture of bullying at the hospital trust I work at. Colleagues have been suspended for raising concerns over unsafe patient care and allegations of abuse towards patients. One colleague had to leave her job after whistleblowing and is undergoing counselling for post-traumatic stress disorder. In my case, the bullying was incessant – my line manager would call me in the evening at home telling me to take time off work and encouraging me see my GP as, in her opinion, I was unwell – I wasn’t. She insisted that I had to contact her every morning to tell her where I was, even at work. Other senior people soon started to target me and I would be admonished for the smallest of errors and for things I hadn’t done. Because of the seniority of these people, other members of staff began to pull away, and I soon became isolated. By this time, I had gone to see my GP who had diagnosed me with severe depression. I have had suicidal thoughts – occasionally I still do. I’ve been demoted and moved into a job where I have no experience and I’ve been offered no training; I’m being set up to fail. I’m resigned to the fact that I will have to leave the trust at some point, as I can’t carry on. The bullies have wrecked my career in the NHS, and my confidence in my ability has evaporated. The whole experience has had a profound effect on me – cheerful confidence has been replaced by paranoia and distrust; I will never be the same person again. To this day I do not know what I did wrong – if anything.