Health Service Focus

06.03.20

Tackling toxic tribalism in the healthcare service

Richard Peachey, HPMA Regional Committee Member and Employee Relations Consultant, CMP

It’s not surprising that relationships within groups of senior hospital doctors and consultants can become fractious. The levels of pressure and stress combined with a sense of seniority - they’ve earned the right to be listened to - make for frank, sometimes undiplomatic conversations.

Relationship breakdowns between clinical teams can have serious implications for patient care, management and the running of entire organisational operations. Last year, complex heart operations were moved out of London’s St George’s Hospital due to an above average death rate. Care Quality Commission inspectors found a “toxic” culture where surgeons with strong personalities had become unable to work together effectively. There was tribalism among groups of consultants, cardiologists, anaesthetists and senior leaders, who’d begun to mistrust each other.

The quality of conversations is the problem. It’s an essential issue highlighted by the Civility Saves Lives charity, set up by healthcare professionals to emphasise how rudeness in clinical situations leads to errors, stress and lower levels of care.

There’s nothing wrong with ‘difficult’ conversations, with an honesty that clears the air and provides a basis for moving forward. But those kinds of conversations

require a particular set of skills. Often there’s an assumption that the most senior staff, so obviously possessing the highest levels of technical expertise and intelligence, will have people skills and a limitless stock of maturity by default.

Our experience of workplace relationships, across NHS bodies, emergency services, local authorities and Government departments, has shown the importance of developing ‘Conversational Intelligence’ for all levels of staff. In terms of dealing with divisions between specialist areas, among the kind of people that will identify more with their peers than their employer, there is evidence of the value of group mediation.

Government policy for change and the restructuring at one primary care trust, for example, was creating a climate of uncertainty and stress across the organisation. A review was conducted of the relationship between management and trade union representatives, which appeared to have suffered a breakdown in partnership working. Formal meetings had been fraught and tense, leaving participants feeling angry and under attack and relationships between both sides were starting to collapse.

Group mediation was introduced: a process that typically begins with private talks with each member of staff to build rapport and

identify the issues from their individual perspectives. Small group mediations are carried out over a number of weeks before the mediator brings the team together to rebuild trust and working relationships. People feel able to be frank about their views and feel listened to, and for effective ways forward to be mapped out in terms of specific and measurable agreements. The process serves to dispel some of the myths and misunderstandings that have grown into a tangle, defusing people’s negative emotions and finding ways for people to relate more effectively.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Kindness is key to overcoming Covid-19 crisis

26/05/2020Kindness is key to overcoming Covid-19 crisis

Nuno Albuquerque, Group Treatment Lead, UK Addiction Treatment Group, explains why your mental health is just as important as washing your hands ... more >
UK study to examine Covid-19 impact on blood cancer patients

26/05/2020UK study to examine Covid-19 impact on blood cancer patients

A new UK study is being launched by IMPACT to examine how patients receiving stem cell transplants for blood cancers and blood disorders react to... more >
Pre-diabetes: a hidden healthcare problem

26/05/2020Pre-diabetes: a hidden healthcare problem

Dr Russell Muirhead, Clinical Director of Living Well, Taking Control A third of adults in England have pre-diabetes, according to research pu... more >

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 e... read more >

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 th... more > more last word articles >

the scalpel's daily blog

Pre-diabetes: a hidden healthcare problem

26/05/2020Pre-diabetes: a hidden healthcare problem

Dr Russell Muirhead, Clinical Director of Living Well, Taking Control A third of adults in England have pre-diabetes, according to research published in The BMJ. The study also found that, over eight years, the number of people diagnosed with pre-diabetes tripled. By 2025, it is estimated that five million people will have diabetes in the UK – 90% of which is Type 2 diabetes. Pre-diabetes is related to increasing rates of obesi... more >
read more blog posts from 'the scalpel' >

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 health and wellbeing. As the best rugby players in the world repr... 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. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... 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 conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >