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Can Arrowe Park show other trusts how to beat the bullies?

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It wasn’t supposed to be like this. Another story of a bullying culture among nurses in an NHS trust has emerged, just under five years since the Francis Report sent shockwaves across the country.

In the months after the devastating report into care failings at Mid Staffordshire Foundation Trust was published there was a real sense that this time things really would change.

Francis was not just another report that would gather dust after an initial flurry of empty promises – this time healthcare providers and health professionals would act, and organisational cultures would change. Over 100 NHS organisations made public declarations of intent by signing up to Nursing Times’ Speak Out Safely campaign.

But reading the report on Arrowe Park Hospital, part of Wirral University Teaching Hospital Foundation Trust, gave me a feeling of déjà-vu.

“Instead of donning blinkers and earplugs, the board conducted a confidential listening exercise with staff – and staff didn’t hold back”

Once again A&E is a focus, and once again the problem has gone on for years, with nurses undermining colleagues in front of less-experienced staff, off-duty rotas being used to isolate and punish, and colleagues being set up to fail.

“Instead of donning blinkers and earplugs, the board conducted a confidential listening exercise with staff – and staff didn’t hold back”

And once again, it took a whistleblower to shine a light on the situation.

Sadly, comments on our news story suggest Arrowe Park isn’t alone in having a bullying problem.

But there are some causes for cautious optimism.

Unlike those at Mid Staffs, senior managers at the Wirral trust acted when made aware of the situation.

Instead of donning blinkers and earplugs, the board commissioned an independent company to conduct a confidential listening exercise with staff – and staff didn’t hold back. They were admirably frank in telling their stories.

Granted, the original whistleblower felt the need to remain anonymous, but the experiences of past whistleblowers would put all but the bravest off identifying themselves. However, staff felt confident that their confidentiality would be maintained during the listening exercise, and that hasn’t always been the case in the past.

“Culture change is never easy, but the trust has clear evidence of its problems and some constructive recommendations on how to proceed”

Another positive is the fact that patient care seemed remarkably unaffected. With one exception, staff said they would still be happy to have a relative cared for by the colleagues they were expressing misgivings about – they may have been unpleasant colleagues but they were still good nurses.

The investigators observed only one instance of poor care in four observed shifts, and said this stood out because it was an exception.

At Mid Staffs the quality of patient care had simply fallen off the trust’s agenda. While staff suffered in a bullying culture, the real pain was felt by patients treated with “callous indifference” – for example being left covered in faeces for long periods, or with drinking water left out of reach.

The trust has committed itself to addressing the situation at Arrowe Park and says senior managers are supporting A&E staff through the process. Culture change is never easy, but the trust has clear evidence of its problems and some constructive recommendations on how to proceed. Maybe it can show other organisations how to face down the bullies.

 

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