Daily Insight: ‘Toxicity, cronyism and bullying’

The first report into safety and culture at University Hospitals Birmingham has dropped.

As many expected, medics who contributed to the first of three reviews – this one by Professor Mike Bewick on patient safety – were scathing in their descriptions of poor culture and bullying.

The former NHS England medical director’s team heard repeated reports of “long-standing bullying” and “toxic” work environments, while senior medics at UHB’s tertiary site Queen Elizabeth Hospital in particular levelling serious accusations at leaders of “cronyism” around appointing senior leaders and in HR processes.

Their concerns included a lack of competency in running the organisation and impact on basic clinical care, “cronyism” at every level of medical management appointment up to executive level, a lack of confidence in the executive team, compounded by dysfunctional disciplinary processes and poor handling of “overt bullying and microaggressions”.

Meanwhile, UHB’s approach to management was commonly reported as “overzealous and coercive”, the report said, and senior handling of a junior doctor’s suicide in 2022 was described as “callous” and lacking empathy.

Professor Bewick wrote that the trust was safe, but that “any continuance of culture that is corrosively affecting morale threatens long-term staff recruitment…” and will put patients at risk.

Yesterday it was also announced that former UHB chief executive Professor David Rosser has decided to retire. He left UHB last December to take up a newly created role of strategic director for digital health and care across the West Midlands.

A bloody fallout

Three years on from a hard-hitting report into racism at NHS Blood and Transplant, the fallout from that review continues.

In 2020, Globis Mediation Group found “systemic” racism at one of the agency’s major sites, but serious questions around the response to that report have been raised in recent weeks.

Earlier this month, HSJ revealed an internal report from October 2022, which found that progress against the recommendations from Globis had been poor, and the agency had sought to muddy the waters by commissioning another firm to assess its progress.

The internal report even went as far as to say there had been “deliberate attempts to conceal” the problems.

Since then, we’ve seen another internal document, produced in January 2023, almost three years since the Globis report, which suggests there are still huge tensions within the organisation around those findings.

It talks of inaccuracies in the Globis work and apologises to certain staff groups who were implicated. However, sources say the statement was never agreed by the NHSBT’s network of ethnic minority staff, who felt it was trying to rewrite what had happened and would undermine the antiracism agenda.

As one of the things staff have been calling for is greater diversity of leadership at NHSBT, HSJ has also looked at appointments to the board and was struck by the situation.

Since the Globis report was received, 15 white people have been appointed to board positions, including interims. The one appointee from an ethnic minority in that period left within nine months, after going on extended sick leave.

Meanwhile, beneath the board level, two successive chief diversity and inclusion officers – both from minority ethnic backgrounds – have left the organisation on secondment, both within 18 months of being appointed.