latest health care news

26.06.18

Scathing government review into NHS region blasts bullying and blame culture

A government-backed review into a major Scottish region has uncovered a culture of bullying and harassment where concerns raised were discouraged, with staff made to feel they had been “blamed rather than supported.”

The review into NHS Lothian, a region which serves around 800,000 people, including all major services for Edinburgh, found that a lack of structured and robust management led to confusion and poor focus on patient safety experience.

Ordered by the Scottish Government, the scathing review blasts the leadership team at NHS Lothian, highlighting a breakdown in trust between medical and nursing staff in the A&E department, with senior management’s attempts to resolve the issue proving “unsuccessful or detrimental.”

Following a whistleblowing letter sent into NHS Lothian – raising concerns regarding the validity of the region recording of breaches of emergency care at the St John’s Hospital site – news broke in December that waiting times of under four hours at every acute hospital ran by the area had been under-reported.

Chair of the Scottish Academy of Medical Royal Colleges Professor Derek Bell was subsequently asked to lead the review, which, through a series of interviews with board members and a range of other staff and stakeholders, found that the situation required “urgent action” on practice and management in the area.

The review team found that patient safety and quality of care was “not always prioritised as it should be,” adding that patient flow was not owned by everyone and largely left to nursing teams to manage.

‘Confusion and lack of focus on patient safety’

“The site leadership teams were variable in terms of experience and skills, including the roles and responsibility of the management and clinical leads. This may have contributed to a lack of consistency in senior leadership roles across the sites leading to confusion and a lack of focus on patient safety and experience,” the report added.

“This was particularly evident within the medical leadership.”

Management at the organisation was heavily criticised, including meetings involving the discussion and reflection of operational issues that were found to be “frequently deprioritised, cancelled or had poor attendance.” Staff described internal communications at NHS Lothian as variable, with limited opportunities to give views on new developments.

But despite the acute care failings, there was “clear commitment” from all staff to improve care for patients in the emergency department.

Amongst its recommendations, the review team called on board members to clarify the governance structure and supporting framework, with high-quality, safe care for patients as the key objective.

The inclusion of site leadership teams with visible support of good governance practice was another key area to be focused on in the future, the review team noted. In addition, a more transparent culture within NHS Lothian allowing staff to air concerns and the adoption of a team-based approach to the management of the four-hour standard were also a number of recommendations made to the Scottish Government.

Jim Crombie, interim chief executive at NHS Lothian, accepted the findings of the report and apologised for staff members who have come under intense pressures for the failings of the board.

He added: “We welcome today’s finding, which accords with our own, that staff had not amended breach times to deliberately falsify performance but instead that confusion had led to these mistakes. Our staff do an incredible job in difficult circumstances.  I am proud of them and note the review team found a number of examples of excellence in team working and inclusion.”

Enjoying NHE? Subscribe here to receive our weekly news updates or click here to receive a copy of the magazine!

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

featured articles

View all News

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us throu more > more last word articles >

health service focus

View all News

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental ... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Bei... more >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual... more >

the scalpel's daily blog

NHSCFA: Never get bored of fraud

31/03/2020NHSCFA: Never get bored of fraud

Matthew Jordan-Boyd, Director of Finance & Corporate Governance, NHS Counter Fraud Authority (NHSCFA) I have written several articles about the work of NHSCFA and tha... more >
read more blog posts from 'the scalpel' >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital exemplars who were revealed at the same show 12 months earlier.  Jeremy Hunt also stated that by the end of 2018 – the 70th birthday... read more >