NHS Lothian report reveals 'bullying culture' and 'atmosphere of fear'

A review into the management of NHS Lothian has highlighted an "inappropriate management culture".

The report was carried out after it was found the health board had been manipulating waiting times figures to meet targets.

Staff interviewed said there is a culture of "bullying and intimidation" at the organisation. Some described it as "an atmosphere of fear" with others talking about "a blame culture".

Members of staff said they were intimidated into doing things, with threats of losing their jobs if they did not.

Statements made to staff are said to include: "If you don’t reach your targets you can collect your P45" and "those of you with mortgages and career aspirations had better be afraid".

Health secretary Nicola Sturgeon said the report showed a management style that would "not be tolerated".

Two members of staff had been suspended after it emerged in October last year that the board had asked patients to go to appointments in England. When they declined, they were not included on a list of patients waiting the target of 18 weeks for treatment.

On Friday, NHS Lothian said they would be implementing the recommendations made in the report.

Chairman Dr Charles Winstanley said: "This has been a difficult time for NHS Lothian but this review was necessary and has provided us with a clear way forward.

"Our focus is now on implementing the recommendations and ensuring that NHS Lothian never finds itself in this position again.

"We intend to establish a Steering Group made up of trades unions representatives and non-executive members of the Board to oversee the progress of the recommendations."

New boss

The chief executive Professor James Barbour retired last month in the wake of the scandal and has been replaced by Tim Davidson.

Mr Davison said: "In the short time I have been here I have found an enthusiastic workforce that is very positive about the way ahead.

"I will ensure that the relationship between management and the workforce is open and transparent and that we work in an inclusive and engaging environment where staff feel free to voice concerns.

"I am certain that we can use this report as a way of ensuring NHS Lothian moves forward with confidence and ambition."

Ms Sturgeon said she had asked the health board to come up with an action plan on how they would be improving the organisation.

She said: "I want to be clear that there is no place in any part of the NHS for a management style or culture of this type and it will not be tolerated.

"However, the report also makes clear that this should not be seen as a general condemnation of management within NHS Lothian. Excellent relationships exist within teams and there are many exceptionally good leaders and managers who have been unaffected by the issues identified.

"It will be important now for the board to embrace a new strategic direction and work to embed an inclusive, supportive, open and transparent culture throughout the organisation.

"I fully support the new interim Chief Executive Tim Davison in his and the board’s wider work to rebuild the trust and confidence in NHS Lothian.

"I have now asked Dr Winstanley to produce a single integrated action plan which will bring together the improvements required in waiting time information reporting, governance and culture."

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