Trust staff ‘disrespected’ and ‘pushed beyond their capacity’, review concludes

The external review by consultancy firm The Value Circle said many staff at University Hospitals Birmingham feel treated “like a number on a spreadsheet, and that the best way to get through the day is to keep their head down without confronting or challenging the status quo”.

There have been a series of investigations into problems at University Hospitals Birmingham Foundation Trust over the last year.

The latest report said the size and complexity of UHB, which merged with Heart of England FT in 2018, makes it difficult to behave as a single organisation with one distinct way of working. It said weak communication between teams and sites created unnecessary obstacles leaving many feeling lost about where they fit.

Differences in treatment across the trust’s sites were also described, with many staff believing UHB places a greater sense of value on its larger hospitals.

Problems with male-dominated leadership, as recognised in previous reviews of UHB’s culture, were also highlighted, with women feeling excluded.

Transparency of recruitment into board and senior leadership positions was questioned, with a perception that personal networks carry weight in recruitment to the most senior positions.

Concerns were also raised about the lack of board diversity and the “exclusivity” of the trust’s headquarters, often called the “executive corridor”.

The review said some groups of staff operated “cliques”, with these groups of individuals having more favourable outcomes when providing feedback.

It added that “negative and potentially discriminatory behaviours have been tolerated and accepted”, and staff have become “desensitised through consistent lack of accountability for poor behaviours”.

Survey data from around 3,000 staff indicated more than half felt bullied or harassed at work and just 16 per cent thought UHB would deal with their concerns. Almost half of junior doctors at Queen Elizabeth Hospital felt unable to raise bullying concerns without fear of reprisal, half felt bullied or intimidated, while 53 per cent had witnessed a colleague being mistreated.

Recommendations included for UHB to build on recent board changes to consider diversity, to review transparency of recruitment to senior positions, as well as the balance of gender across senior medical roles.

Reviewers added that UHB’s board should recognise its cultural issues are not historic, nor are they defined by a single issue. They also criticised UHB for its lack of a sexual safety policy and said it must implement one immediately.

Jonathan Brotherton, who was chief operating officer before stepping up to CEO earlier this year, said: “We are very sorry for the unacceptable behaviours and working practices that the culture review highlights and welcome the recommendations, which we fully commit to implementing.

“While the review makes very difficult reading, it resonates with what we have heard directly from staff. We have begun putting into place changes in structure, and in leadership, which will provide a good foundation for the further actions we need to take to improve morale and address staff concerns.”