• Sheffield CCG’s improvement plan sets out leadership development strategy.
  • New interim chief was “concerned” to hear of bad staff experiences.
  • Pledges to support staff better when pursuing bullying cases.
  • Independent director Mike Potts will stay on as “critical friend”.

A clinical commissioning group accused of having a “toxic” culture will bring forward a review of its whistleblowing policy and give “even more support” to staff pursuing bullying and harassment cases, an improvement plan has recommended.

Sheffield CCG should also give “ongoing attention” to recruitment, performance management and grievance processes, the plan has said.

The improvement plan, which was published at the CCG’s July board meeting yesterday following several delays, also said the executive team needed to consider how its actions are perceived by staff and any sustained disagreement between individual directors needs “urgent resolution, with external support if needed”.

The plan said the CCG needed to understand the specific issues in its nursing directorate and draw up an organisation‐wide plan, under the leadership of the chief nurse with a governing body sponsor.

Other recommendations made in the improvement plan included:

  • Strengthen commissioning arrangements with the local authority
  • Review the governing body constitution
  • Undertake a skills audit of the executive team
  • Appoint a clinical lead for children’s commissioning
  • Instigate a programme of corporate leadership development for the executive team and then cover the wider leadership team

Feedback from CCG staff during the consultation period for the improvement plan was critical of senior management and the governing body.

One staff member said: “Please can our directors not make decisions based on what will make them look good but look at the wider team and the impact it has on the people below.”

There was also critical feedback about “the manner in which staff are challenged and about staff not being held to account”.

The CCG has established a steering group, which will have “oversight of implementation” and ensure the “intended impact of the actions [are] being achieved”. It will be accountable to the governing body and report regularly on progress made.

The improvement plan was launched following a critical independent investigation of the CCG, which identified issues of poor behaviour by senior CCG staff, dissatisfaction over the handling of bullying and harassment cases, poor relationships between members of the governing body and a lack of clear strategy.

Multiple sources including current and former staff told HSJ the culture in the CCG was “toxic”.

The CCG’s medical director Zak McMurray was  put on “special leave” with full pay for more than a year after he raised whistleblowing concerns about the former accountable officer Maddy Ruff, who resigned last month.

The CCG said it had implemented “a number of changes” since the independent investigation, which include surgeries with executive directors so staff can “discuss ideas and concerns with them”.

Lesley Smith, interim accountable officer, who is also the AO of neighbouring Barnsley CCG, said: “I recognise that not everyone has had the best experience of working at the CCG and I’m committed to delivering our improvement plan to develop a culture where everyone is clear on the value they add, feels valued for what they do and has a great experience of working at the CCG.

“We have listened carefully to what has been said and are really concerned to hear that some staff are having bad experiences of working here,” Ms Smith said. “We delayed the publication of our plan, so we could fully respond to the issues that were raised and give us the opportunity to co-produce the plan with staff and partners.”

It appears to be the clearest acceptance yet by the CCG of some of the concerns reported by HSJ.

Tim Moorhead, CCG chair, who is also stepping down, said: “The governing body is fully committed to making Sheffield healthier and being a great place to work as part of its improvement plan. We fully accept that we need to make improvements.”

The plan was overseen by former primary care trust chief executive Mike Potts, who took on the role of an independent director, and also led by Nicki Doherty, the CCG’s current director of delivery.

In a letter sent from Alison Knowles, NHS England locality director for South Yorkshire Bassetlaw, to Ms Smith and Dr Moorhead, it was confirmed Mr Potts would remain at the CCG until October 2019 as a “critical friend” to ensure the CCG deliver its objections within the “ambitious timescales” set.