Staff fearful of reprisals if they speak up amid hospital investigation, report finds
Asked to review University Hospitals Sussex, the report's authors said they 'repeatedly heard concerning examples of staff, often at a senior level, being ignored, dismissed and sometimes ridiculed when speaking up.'
The report by Niche Health and Social Care Consulting said this fear of reprisals from whistleblowing could be harming patient safety. It also highlighted complaints of misogyny and failures to deal with 'unwanted romantic advances'.
The review team noted a number of challenges facing the trust, including an investigation by Sussex police into possible corporate and individual manslaughter charges over allegations of medical negligence and cover-up in the general surgery and neurosurgery departments. Operation Bramber is focused on the deaths of more than 90 patients, and serious harm suffered by more than 100 others. It was sparked by the concerns of two consultant whislteblowers who lost their jobs at the trust after speaking up, first revealed in the Guardian in June 2023.
The report found staff feared their careers could be hindered if they raised concerns. One said they had been told not to share data that made the trust look bad. Another said when they did raise concerns they were 'gaslit' and targeted by management.
The report identified 'significant issues with psychological safety at every [staff] level' and noted that the fear of speaking up had worsened in the last year. It said staff identified as having the potential to disagree with management said they were deliberately ignored in meetings.
A staff survey conducted for the review received 376 responses of which more than 300 were negative or very negative on the issue of speaking up. The responses often cited a 'fear of reprisals'.
One said: 'There could be comeback which will affect your career in [a] negative manner.' Another said: 'I raised concerns. It put a target on my back. Management lied, gaslit me, would circumvent the issue, would dismiss my concerns.' A third said: 'I feel no one listens.'
Staff complained that the executive team discouraged bad news and different opinions. The review identified a 'predominance of direct and authoritative leadership styles'. It added: 'We heard repeatedly that 'there is a parent-child dynamic in this organisation'.'
It also found that 'incivility and poor behaviours appear to be pervasive' and there was a strong view that these were tolerated by leaders. The report did not give details of these behaviours. Last year the Guardian revealed that a consultant surgeon was promoted after allegedly assaulting resident doctors during surgery.
Six senior women at the trust complained to the reviewers of misogyny, which was felt to be prevalent among consultants. Female staff said they faced eye rolling and other signs of dismissiveness from male colleagues when they spoke at meetings. They also faced pejorative references to sexuality when they took the lead.
One woman claimed she 'experienced unwanted romantic advances and inappropriate comments, with no actions taken months after reporting this to various senior leaders.'
Earlier this month the trust chief executive, George Findlay, announced his departure.
Andy Heeps, the acting chief executive, said the trust accepted all the report's recommendations for improvement and its 'valuable insight into what we do well, where we are improving, and where there is clearly more to do'.
He said: 'The authors recognise the scale of the task in completing such a huge trust merger during the Covid pandemic, and highlight a number of key improvements such as our big reductions in waiting lists and key service quality improvements.
'But they also draw attention to some fundamental issues which we've not yet succeeded in tackling – and all of these things need to change, and change quickly.'
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