The must read stories and debate in the NHS

Bullying scandal

More than half of NHS England black and minority ethnic staff reported being personally bullied by their line manager in an internal survey, HSJ revealed on Wednesday.

The “deep dive” survey of BME staff at the national commissioning body found 55 per cent of respondents had been bullied by a line manager since starting work at the organisation. It also revealed 36 per cent – or 58 out of 163 people – said they experienced bullying, harassment or abuse at work based on their race. 87 per cent (98 people) said their ethnic background was a factor in unfair decisions about their career progression.

The survey, leaked to HSJ, asked staff a series of questions based on their experience since they joined the organisation. 

It was carried out in February and March this year after NHS England’s main staff survey identified that BME staff were more likely to be discriminated against than their colleagues.

Other key results from the BME staff survey included:

  • 53 per cent said they had a good or very good experience of working for NHS England;
  • in response to a question on the causes of sickness absence “a large number” identified anxiety as a lead cause; and
  • 6 per cent were subject to a disciplinary and 9 per cent had submitted a grievance.

Good luck in Lewisham

If you wanted, you could see the late-year travails of south east London trusts as the curse of South London Healthcare Trust.

In 2013, Jeremy Hunt completed what Andrew Lansley started and formally dissolved the organisation, giving one of its hospitals to Lewisham, one to King’s and leaving the third to be managed as a kind of Switzerland with cantons run by different providers.

Lewisham’s absorption of the Greenwich part put non-payment of PFI support, bizarre wrangles with commissioners and involvement with Circle and competition law on the board’s plate.

This is all by way of saying good luck to Ben Travis, the new chief executive at Lewisham and Greenwich Trust. The job was described by one figure in the system as “a difficult ask”.

A report into the financial governance of the trust earlier this year found some loose practice around the hiring of consultants and the like, but fundamentally showed an organisation being asked to do improbable things by its regulator.

These included a savings plan equalling 8.6 per cent of turnover, the closure of seven wards and a reduction in the average length of stay from 8.1 to 4.7 days.

Whether Mr Travis will be charged with delivering this kind of miracle remains to be seen.

Keeping the training wheels on

This week one of the most troubled trusts in the country had its CQC rating upgraded from requires improvement after being rated inadequate last year.

Despite this achievement, NHS Improvement has decided to keep the trust in special measures, in the hope that keeping the training wheels on will help push the trust over a few more quality and safety jumps.

There are four other trusts rated requires improvement that are still in special measures and this may become a trend.

There is one hurdle in particular that is likely to have informed the regulators’ decisions: maternity services. The trust may have received good or requires improvement for most of its services but the CQC were scathing in its report on maternity services. This department was also the focus of the CQC’s last inspection and it seems the trust has been unable to make enough improvements to the service.

Perhaps the most worrying thing is the reported “bullying culture” within the maternity teams – something the trust has failed to improve since 2016.