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NHS: Bullying

Volume 798: debated on Wednesday 5 June 2019


Asked by

To ask Her Majesty's Government what are the latest figures for bullying in the National Health Service; and what are their plans to reduce the level of such bullying.

My Lords, the Government are committed to supporting NHS organisations in their responsibility to tackle bullying. Some 28.3% of staff responding to the 2018 NHS staff survey experienced bullying from patients, service users or the public, 3.2% from managers and 19.1% from colleagues. Through the NHS Social Partnership Forum’s collective call to action and commitments in the NHS people plan, the Government are working with these arm’s-length bodies, the royal colleges, the NHS national “freedom to speak up” guardian, NHS organisations and health unions to reduce levels of bullying for all staff, and they deserve our thanks for all their work.

I thank the Minister for her Answer. As she indicated, the NHS depends entirely on the commitment and dedication of its staff. It is really appalling that 28% of them experienced bullying and harassment in the last year alone, as she said. Just 12 months ago, her predecessor as Minister told me that over 70,000 members of staff had suffered physical violence in the service, and those figures are three years old. That is indefensible. We need to protect these employees. Will she make it clear that physical attacks will simply not be tolerated? Will she upgrade the service’s register of violent and abusive patients, relatives and friends, and will she confirm that there will be zero tolerance against physical attacks on our NHS staff?

I thank the noble Lord for his Question and I share his outrage. We absolutely must have zero tolerance of violence against any NHS workers, wherever they work within the National Health Service. That is exactly why the Secretary of State made a commitment to the national NHS violence reduction strategy, which was launched on 31 October 2018. It will put in place arrangements to support trusts in their responsibilities to protect staff. The recommendations include improving governance, improving staff training and development, improving the work environment and better use of legislation, including the new Assaults on Emergency Workers (Offences) Act, which had its first conviction in November. That is a significant improvement, but we know that improving general morale and the workforce environment are important, which is why we published the people plan this week.

My Lords, zero tolerance is really important in a workplace, but what are the Government doing to ensure that more senior managers and clinicians do not sexually harass and bully more junior staff?

My noble friend is right that we must ensure that bullying, wherever it comes from, is reported. It is just as unacceptable that bullying should come from managers and senior people as from those below. As I said in my Answer, the reported level of bullying from managers is 3.2%. This is one reason why we have introduced the “freedom to speak up” guardian, so that NHS workers are free to speak up and feel that they can do so in a safe space.

My Lords, the interim report by the noble Baroness, Lady Harding, on NHS staffing highlights persistent shortages of staff, particularly of registered nurses, in many parts of the NHS. To what extent does the Minister believe that bullying is associated with managers focusing on NHS targets without sufficient staff to deliver high-quality care?

The Interim NHS People Plan identified bullying and violence in the workplace as a key challenge that must be addressed, and identified some measures to address them. However, the noble Baroness is absolutely right that an underlying challenge is staffing, which is a major concern for the NHS workforce. The plan looks to address them in a serious and concerted way by recruiting more staff, retaining existing staff, and looking at innovative ways to entice former staff back into the NHS so that we reduce the pressure on the entire system. She will know that the plan includes commitments to recruit 40,000 more nurses over the next five years and to reduce the vacancy rate to 5% by 2028, down from the current 8%, and reiterates the commitment to recruit 5,000 more GPs on top of the 20,000 extra support staff to be recruited in the coming years.

My Lords, in addition to the figures cited by the Minister at the beginning of this Question, it has also been revealed that a number of hospital trusts still use non-disclosure agreements effectively to gag people when there has been a resolution to an incident. What guidance do the Government provide to NHS England to ensure that so-called gagging clauses are used only on sensitive matters, such as any compensation payment, and absolutely not to stop whistleblowing?

The noble Baroness is right that non-disclosure agreements cannot cover up bullying. All staff are free to speak up. Non-disclosure agreements should not be used for that purpose in any case. The Government have been very clear on this.

My Lords, I am sure noble Lords will recall my maiden speech 21 years ago, when I spoke about bullying in schools. One of the points that I made then, and I shall make again now, is that an answer to this problem is an independent hotline which people can ring to report misconduct of all kinds, not just bullying, so that organisations do not seek retribution for those who report misconduct.

I am afraid I was not here 21 years ago to hear the noble Lord’s maiden speech, but I shall look it up with utmost urgency upon leaving the Chamber and I thank him for his proposal. As the work moves from the interim people plan to the people plan, in which the work on bullying and the violence reduction strategy will be developed, I am sure that his proposal will be considered as a very sensible plan.

The CQC takes this extremely seriously. One proposal in the people plan is for the CQC’s scorecard to include a proper measure of a sustainable workforce, so that the new staff engagement metrics for the NHS oversight framework can be taken into account in the CQC’s well-led assessments during inspections, and that includes questions about bullying.

My Lords, I hope that my noble friend will agree that good leadership in the NHS is critical to removing a bullying culture. In that respect, might the Government support the NHS Leadership Academy to the extent that all aspiring chief executives in the NHS should themselves have gone through its Aspiring Chief Executive programme?

My noble friend, as ever, makes a very good point. Obviously there are a number of routes where leadership has been shown on this issue. In 2016 the Social Partnership Forum, which is chaired by Ministers but works across the system, gave a call to action, tasking employers and trade unions in all NHS organisations with working in partnership to create positive workplace cultures and to tackle bullying. In addition, recognising that no one organisation has the answer, royal colleges and others have joined together to create an alliance to tackle workplace bullying. They concluded that:

“Bullying behaviour is unacceptable. It is unprofessional and unnecessary. It affects the wellbeing of individuals and the teams within which they work”.

My noble friend’s proposal is another part of the picture. We need to come together across the system to tackle a completely unacceptable set of behaviours in the NHS—one that needs to be stamped out entirely.