Exclusive: Trust 'mired in grievance culture'

The report into Whittington Healthcare Trust, obtained by HSJ, identified “a perception of an ineffectively managed institution” which had become “mired in a grievance culture”.

The north London trust commissioned the report from Duncan Lewis and Longbow Associates in response to above average scores for bullying and harassment in the NHS Staff Survey.

The report, delivered in July 2018, is based on six months of investigation, 120 hours of interviews and survey responses from 1,100 staff. It recommended “immediate actions” to counter perceptions that the executives were “ineffective”.

In particular, the report noted: “A colleague who regularly attended meetings with members of the executive commented how some executive members acted inappropriately, pulling faces, doodling and sending messages to each other covertly.

“Whether this is merely a perception or not, it allows others to sense the executive as ineffective and unprofessional.

“The researchers encountered numerous conversations where frustrations were aired about certain members of the executive who were ’‘ineffective’ leading to perceptions of a ‘crumbling situation because of [redacted]’s inadequacies’.

“This was a consensus view by several senior managers, including other executive members, and this now requires immediate actions.”

The trust had a worse than average score for the proportion of staff saying they had experienced harassment, bullying or abuse from staff in last 12 months, in the 2017 and 2016 NHS staff surveys.

‘Laissez-faire’ or ‘hostile and abrasive’

The report said, while there were no obvious signs of bullying or harassment among the executive, ”there are well-defined problems of examples of ineffective leadership”.

It continued: “These include a belief from many staff of a ‘collusive’ and ‘cosy’ executive who lack a willingness to challenge their own and other’s behaviours.

“Underpinning this view is a perception of a laissez-faire approach to leadership by some, and a hostile and abrasive approach to employee concerns by others. Both claims appear to have some basis.”

Senior medical staff were also singled out for criticism. The report’s authors noted: “We heard countless examples of very inappropriate behaviour by senior staff, including senior medical staff, which must not have existed in isolation. Evidence was repetitive and the impact upon some staff considerable.”

Staff described being afraid to open emails from or go to meetings with some managers, and described feeling ”broken” by the experience.

Recommendations for senior staff in the report included not shouting or swearing. The report said: “Role modelling behaviours is important. If senior staff shout and swear this sets a poor example to other staff.”

It also said staff raising concerns about other’s behaviour “must be taken seriously”.

The report praised the accessibility and visibility of former chief executive Simon Pleydell, who left in 2017, and current chair Steve Hitchins. But it added that aggrieved staff often went straight to them, complicating the proper functioning of grievance or disciplinary processes.

A pay differential between community services staff working in Islington and those working in Haringey was also a significant source of resentment.

‘The status quo is not an option’

The report said: “It is clear that, in commissioning this research, the trust has begun to put in place a strategy to properly tackle bullying and harassment.” In particular, it noted a significant overhaul of the HR function had taken place.

It said: “In many ways [the trust] already has sufficient systems and processes in place to adequately tackle bullying but requires a more interconnected pathway to unite these elements into a coherent whole.

“Central to this is a requirement for leaders and managers to be willing to embrace sensitive matters that sometimes they themselves are at the heart of.”

Siobhan Harrington became the trust’s chief executive in September 2017. The report said she ”must therefore prioritise this issue with her executive team and hold to account those whose actions have significantly contributed to such levels of disquiet amongst the workforce”.

It continued: “The status quo is not an option and the executive needs to recognise their actions and that others see them as role models. However, and importantly, senior medical staff are also part of the leadership at WH and they too must be cognisant of their behaviour.”

The trust’s response

A trust spokeswoman said: “We proactively commissioned last year’s culture review in light of staff survey results. While the review showed that this was not endemic in our organisation, it did help to identify how we could work together to make changes going forward.

“We followed this up with listening events with over 500 staff across all grades and disciplines which provided us with valuable insight into where we need to focus. We have taken a number of actions to increase opportunities for our staff to feedback or raise concerns, support individuals and teams and drive improvements against the Workforce Race Equality Standards.

“There is still more work to do but we are committed to focusing on tackling bullying and harassment and improving engagement with staff.”

The trust said, since the review’s publication, it had set up an inclusion network for staff, recruited a full-time Freedom to Speak Up Guardian, introduced a new mediation scheme and was running a clinical leadership programme for staff in band six and seven roles.

There is also a new fair treatment panel to look at cases before they reach the disciplinary stage.