A third of staff at the NHS trust that runs the BRI and Bristol Children’s Hospital do not feel 'safe' to speak up about dangerous practices or issues such as racism and bullying, a damning report reveals. And only half have confidence that University Hospitals Bristol & Weston NHS Trust (UHBW) would actually do something about it if they did.
Some courageous hospital workers who do raise concerns are labelled as “troublemakers or agitators”, which further undermines the organisation’s Freedom to Speak Up (FTSU) campaign because it stops others from bothering in the first place, a UHBW board meeting heard. Bosses called the report “uncomfortable reading”, accepted its findings and vowed to change the trust’s culture by listening better to staff.
The annual FTSU report said: “The latest NHS staff survey results show a further decline in the percentage of respondents who felt safe to speak up and had confidence in the trust’s response if they did speak up. Only two thirds of the staff who responded said they felt safe to speak up and just over half felt confident in the trust’s response.
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“In some rare instances, individuals are seen as troublemakers or agitators, and their concerns can be dismissed/not taken seriously. No-one should be labelled in this way.
“There are concerns which have not been resolved even though they were raised some years ago via the FTSU process and subsequently closed. This lack of perceived response has a detrimental impact on the culture and the effectiveness of the FTSU process.”
It said that while the survey’s results placed UHBW above the national average, “it is not good enough”. The report said: “Staff were concerned about confidentiality, confrontation and challenging difficult personalities.
“Some comments indicated that there was a fear of retaliation from speaking up. There was also some frustration expressed in relation to concerns/issues not getting resolved in a way that staff members consider satisfactory, as well as frustration around actions taking a long time to implement or actions/change not actually materialising.
“A further example relates to the issues of racism, discrimination and microaggressions experienced and raised by staff in August 2022 and identified by the Care Quality Commission in their inspection of Weston General Hospital. The feeling from some staff is that more work needs to be done around communicating and engaging with staff to demonstrate that the trust is taking the issues seriously and to share the actions it is taking.”
It said 109 cases were raised through the whistleblowing scheme in 2022/23, of which six related to patient safety, 10 about bullying or harassment, 20 in relation to worker safety or wellbeing and 27 about inappropriate attitudes or behaviours. The report said work to improve recruitment processes had resulted in a “sharp decline” in complaints about nepotism and unfairness.
UHBW director of corporate governance and FTSU guardian Eric Sanders told the board the majority of complainants had received a positive response from the organisation but that managers should have dealt with their concerns in the first place. He said: “There is further work that this organisation absolutely needs to do to encourage a different culture where staff feel able to speak up and raise concerns.
“The key message for me is to think about the individual, have compassion for the individual and have some humanity, to think about how we can compassionately respond to individuals when they raise concerns, and do things differently with that in our minds.”
UHBW chief executive Eugine Yafele told the meeting: “There are aspects of the report that are incredibly uncomfortable to read – the experiences of colleagues in the organisation. Walking around the hospital, people are often stunned that you stopped to talk to them. One of the things that I hear – and it’s always a moment of heartsick – is ‘We see our managers wearing suits and they never talk to us’, and if we aren’t making ourselves accessible as leaders then people aren’t going to raise concerns.
“So there is something about going back to first principles here. We are very much a ‘head’ organisation where we look at the logic and how do we respond, as opposed to ‘we listen, we understand’ then we ask ‘what’s the best way we can support?’.
“Culturally we have some way to go. There is a golden opportunity for us not to do what we’ve always done.”
Board chairwoman Jayne Mee said: “One of the things I would like to see different in this report in 12 months’ time is that people are taking self-ownership for solving problems and talking, listening an d really working things through. The trust is not a ‘thing’, the trust is everybody. We need to listen to our people and help them resolve issues.”
