Culture of Bullying at Liverpool Community Health NHS Trust Laid Bare

A major new report has suggested that bullying is a serious problem in the NHS in Liverpool.

The review highlighted “failures at multiple levels” at Liverpool Community Health NHS Trust since 2011.

It was even suggested that the bullying of staff in the trust could have contributed to some deaths in the region.

For example, one individual who was suffering from lung cancer was not diagnosed for a period of four months due to what was considered to be unwarranted bullying.

In response to the report, the trust has acknowledged that the issues had gone unchecked for a critical period of time, and has resolved to make significant improvements to its overall culture.

Jackie Smith, chief executive and registrar at the Nursing and Midwifery Council, confirmed that investigations were underway regarding some of the complaints unearthed by the research.

“We can confirm that we are investigating a number of individuals from Liverpool Community NHS Trust on allegations of misconduct.”

The trust delivers community health services to about 750,000 people in Liverpool and Sefton, either in their homes or at health centres.

Law firm Capsticks conductied the review, after the hierarchy of the trust received reports that bullying was indeed an issue within the organisation.

One of the most damning reports revealed by the research was the suggestion that an attack on a health worker, who was ultimately taken hostage and seriously assaulted by the relative of patient, was never fully investigated.

The board’s failure to properly oversee the trust’s in-patient services also led to the serving of two warning notices from the Care Quality Commission in January 2014

“A lack of clear management and leadership” on its health services for offenders, including a failure to “properly understand deaths in custody and the factors that contributed in part to those deaths,” according to the final report.

Commenting on the findings, Sue Page, chief executive at the trust since April 2014, indicated that it had become apparent that there were problems among staff when the report had been instigated two years ago.

“Two years ago, as we talked to staff, it was quite clear there were a lot of things that were clearly very wrong. Some of the staff were incredibly hurt by this and all I can say is a really big sorry on behalf of the NHS. They didn’t deserve it, it wasn’t their fault. We gave Capsticks complete independence and the staff feel it is an unbiased, independent report. A lot more has to be done. The report says we are only just turning a corner.”

Meanwhile, West Lancashire MP Rosie Cooper has called for a public inquiry into the trust.

“This wasn’t just a poor quality job. We are talking about people who lacked basic humanity and appear to have fiddled the records to protect themselves.”

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Monitor Announces New Agency Staffing Cost Cutting Measures

Monitor has announced new measures decided to support trusts across the NHS in managing workforce challenges.

According to the healthcare regulator, data acquired by Monitor just last week on Q1 trust and foundation trust financial performance highlighted the need for concerted further action in the coming months and years.

This data indicated that the NHS is likely to face a deficit of at least £2 billion in the existing financial year.

In particular, Monitor has stated that it is important to address workforce challenges.

Thus, it is critical, according to the regulator, to address the rapid growth of spending on agencies, and to develop a more holistic approach to staffing decisions.

With this in mind, the healthcare regulator has announced that it is to take two important steps in order to address the situation.

These have been taken with the support of the national system leaders in the NHS, and it is hoped that this will enable healthcare professionals throughout the system to meet these challenges more effectively.

A joint letter from Sir Mike Richards, Mike Durkin, Jane Cummings, Sir Andrew Dillon and Ed Smith, has already been distributed to NHS employees, setting out Monitor’s view on how providers should approach the need to ensure safe, quality care for patients on a sustained, financially stable basis.

It was also considered important in the content of the letter to reinforce the need to use guidance and best practices in order to support local judgements regarding the best usage of resources.

Following on from this letter, Monitor has been encouraged by providers to take urgent national measures in order to address pay for agency staff.

It is hoped that this would help encourage workers back into substantive roles within the NHS.

Considering this to be an important issue for the health service, the health regulator has just taken the decision to accelerate the timescale regarding this process.

Subject to consultation, Monitor proposes to introduce hourly prices for agency staff across all staff groups, namely doctors, nurses and all other clinical and non-clinical staff.

Subject to the consultation process, the price caps would ratchet down in two further stages so that from 1st April, 2016, agency staff would not be paid any more than the equivalent substantive worker.

The intention is to put this process in place by 23rd November, 2015.

All trusts would be expected to limit and reduce their spending on agency staff over time, and Monitor will continue to work closely with all trusts to monitor and limit levels of agency use across the sector as the measures are implemented.

The proposed price caps have been developed with, and are fully supported by, clinical leaders in Monitor, TDA, Care Quality Commission (CQC) and NHS England.

Clearly action needs to be taken in order to address the huge deficit that the NHS faces, but many critics of government policy will suggest that increased funding would be more effective than cost-cutting, regardless of the legitimacy of these measures.

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Workforce Minimum Data Set to Play Role in NHS Workforce Training

A raft of important British healthcare institutions have submitted letters to GP practices all over the country regarding the Workforce Minimum Data Set (WMDS).

Health Education England, the Department of Health, NHS England and the Health and Social Care Information Centre (HSCIC) are all involved in this important initiative.

The letter provides important background on the role of WMDS in securing a well-trained workforce for the future.

It also includes details on the upcoming collection of data by the HSCIC, and the steps that GP practices need to take now to prepare.

The results of this process are due to be published before the end of this month.

Meanwhile, data collections will also take place at the beginning of October, with the latest submissions in the process required by the middle of November.

The organisations involved in the process were keen to emphasise that those who didn’t participate at an early stage can still get on board now.

WMDS is intended to help plan a future workforce for the healthcare service that meets the needs of all patients.

As primary care within the NHS comes under increasing workforce pressure, the data gathered as part of the WMDS process is intended to address this highly pressurised situation.

Central to the initiative is also improving staff training within the health service.

The first part of this process is to assemble an accurate picture of the existing workforce in order to fully understand the current skill set within the NHS.

This will make it possible to understand accurately the existing capacity within primary care.

Data will underpin the delivery of the joint 10-point plan agreed by the participating organisations, intended to catalyse the delivery of initiatives to ease workforce pressures in general practice.

This is merely the first year of a continuing process, in which data will be directly diverted into the Workforce Plan for England.

The Health and Social Care Information Centre is the organisation tasked with collecting the workforce Minimum Data Set.

HSCIC will contact healthcare professionals beginning from 1st October, with entries for this stage of the process closing on 14th November.

Healthcare professionals can visit the HSCIC website here.

Guidance documents and further information on accessing the Primary Care Web Tool for submitting data can be accessed here.

More information about the process can be acquired here.

Finally, HSCIC will answer questions directly on the process at Be sure to type ‘Workforce Collection’ in your subject heading when submitting an email.

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London Conference Discusses Latest in Agile

A London conference will examine how to create, implement and sustain Agile in public sector organisations.

The 13th annual Agile Business Conference (ABC 2015) will focus on ensuring that an Agile environment can be sustained across an organisation.

Due to be held in the city of London on the 6th and 7th October, the conference will be aimed at public sector directors, senior managers, CEOs, CIOs, IT directors, senior programme and project managers and other change managers.

The conference comes in the context of continuous change within the NHS, with organisations forced to balance the complex demands of a contemporary health service with often diminishing budgets.

It was before this backdrop that the Agile approach to healthcare was first defined and introduced, presenting a reaction against traditional, heavyweight, regulated and regimented methods.

As a fundamental part of Agile is embracing adaptability and evolution, it is considered to be able to respond more rapidly and appropriately to a continually changing organisational environment.

Thus, the London conference will be exploring how it is possible for public sector organisations to introduce and sustain an Agile environment.

This will be examined not merely in relation to individual projects, but also regarding how an entire organisation can be structured around Agile principles.

The two-day programme of presentations, workshops and interactive sessions is intended to benefit not only those who manage programmes, but also individuals who influence corporate strategy.

With a location in the heart of the city of London at 155 Bishopsgate, ABC 2015 will be readily accessible to both local residents and those travelling from further afield.

Prominent at the conference will be a keynote speech by Stephen Denning, former Director of Knowledge Management at the World Bank, who also has a number of prestigious business accolades on his CV.

Denning will be discussing the ongoing transformation from hierarchical bureaucracy to the radically different staff management practices currently taking place.

Speaking about the forthcoming conference, Mary Henson, chief executive of the DSDM Consortium, which organises ABC together with conference partner UNICOM, stated:

“ABC 2015 recognises just how much Agile has now left the margins and become a mainstream management approach for public sector departments and organisations of all sizes. We will be focusing on the sharp end of this, looking at the challenges in introducing and implementing Agile across the organisation and, so important, the challenges of keeping an organisation truly Agile.”

Full details on the Agile conference are available by clicking here. ABC 2015 will also be sending out regular tweets during the event at ABC 2015.

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Bullying Culture in Worcs NHS Rejected by Independent Adjudicator

An independent report carried out on an NHS trust suggests that it has insufficient policies and procedures in place to deal with bullying.

The investigation carried out by the Good Governance Institute suggests that existing anti-bullying policies at Worcestershire Acute Hospitals Trust (WAHT) are “not fit for purpose”.

During the course of the investigation, more than 700 members of staff across the trust’s three hospitals – in Kidderminster, Worcester and Redditch – were interviewed.

However, it was also found that claims of a so-called “culture of bullying” within the trust were unfounded, and that there was no evidence of “endemic bullying” within the organisation.

The investigation came to light owing to complaints from frontline staff, many of whom stated that morale was exceedingly low.

It was also expressed that employees within the trust had fears about speaking out regarding bullying.

Suggestions that there were problems with a bullying culture within the WAHT were exacerbated by the fact that five A&E consultants within the trust quit simultaneously earlier this year.

Although the more serious accusations regarding the trust were rejected by the Good Governance Institute, the organisation nonetheless highlighted inconsistencies in the way that complaints were dealt with.

Medics were even quoted as stating that the culture in Redditch was one of palpable fear.

According to the final report produced by WAHT, the Dignity at Work policy is not “fit for purpose” either as a document, or with regard to the way it has been administered.

Staff complaints were apparently often dealt with in ways that were inconsistent and confusing.

Speaking on the findings of the investigation,Chris Tidman, interim chief executive at WAHT stated: “We have reflected on the report and approved a comprehensive plan to take immediate action to address the weaknesses identified. This morning we held nine staff sessions, taking the opportunity to talk and listen to our staff.”

This is by no means the first instance of bullying reported within the NHS. Previously, a national survey spanning the entirety of the NHS, published earlier this year, discovered that around 25 per cent of all staff had experience some form of bullying and intimidation.

In February, the entire consultant team running A&E services at the trust’s Alexandra Hospital in Redditch resigned amid claims of a “bullying culture” and a breakdown of the relationship between medical staff and management.

And earlier this year, Lord Prior, the Parliamentary Under-Secretary of State for Health in the House of Lords, suggested that a ‘toxic’ culture of bullying amongst NHS staff is putting the safety of patients at risk.

Nonetheless, for now the opinion of independent adjudicators is that the suggestion of an endemic bullying culture within the NHS in Worcestershire appears to be wide of the mark.

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Kingston NHS Trust Defies Government Pay Guidance in Landmark Move

With public sector pay and austerity still a thorny issue, one NHS trust has taken the law into its own hands.

Kingston Hospital NHS Foundation Trust has decided to award its senior staff a 1% pay rise in line with lower paid staff, in clear defiance of government guidance.

In making the decision, the trust evidently considered the potential impact on staff retention of freezing salaries across pay bands.

In a note on the decision, the trust’s papers stated that the “rationale was that in the light of the recent staff survey results and staff able to work at local trusts who would pay inner London weighting, it was thought that it would improve the retention of staff”.

Earlier this year, the government had agreed to a 1 per cent pay rise for all staff salaried below £57,069, as part of its Agenda for Change pay framework.

But the trust has now defied this decision and become the first to offer an improvement in pay to those ranked above the band 8C grade.

Staff surveys conducted last year certainly indicated that employees working for the NHS in the Kingston region were not overly enamoured with the existing situation.

Forty-seven per cent of the trust’s staff who completed the survey stated that they were either “dissatisfied” or “very dissatisfied” with their pay level.

In this context, it was deemed to much of a risk to freeze the pay of valued employees within the trust, and thus Kingston Hospital NHS Foundation Trust acted in order to retain talent.

Releasing the information into the public domain, the trust also provided data on the potential cost to the public purse.

Increasing pay for staff above the band 8C mid-point will cost the trust £22,000 this year; a relatively trivial figure considering that the trust anticipates a deficit of £8.8 million in 2015 in its overall financial figures.

A spokeswoman on behalf of Kingston Hospital NHS Foundation Trust stated: “While the majority of staff, approximately 2,250, received the nationally agreed 1% unconsolidated pay rise this year, 22 members of staff at the bands 8C mid-point and above, did not.

“To maintain good staff morale and retention within this small group of staff, and to achieve a level of equity against their colleagues, a decision was made by the trust board that staff at band 8C mid-point and above would receive a 1% pay rise for one year only.”

Managers in Partnership, the British Trades Union for healthcare managers, also welcomed the move. Chief executive Jon Restell asserted that “Kingston FT has made a wise decision in the face of increasing pressure on recruitment and retention as the economy improves”, and stated his belief that the move “is the only logical way to push back on agency and interim costs. I hope and believe that others will follow Kingston FT’s example.”

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