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'Trust and culture change are essential to tackle bullying'


Dean Royles, director of NHS Employers, wants to find solutions to bullying in the workplace

The old rhyme “sticks and stones may break my bones but words will never hurt me” starkly demonstrates what those of us involved in the management of people know to be false. Words do hurt.

Bullying in the NHS and elsewhere is a sensitive and difficult issue. The impact on individual staff can be devastating and the impact on sickness absence, productivity and staff turnover is well documented.

Employers in the NHS have made a concerted effort in recent years to tackle this. There is increasing recognition that encouraging a culture of openness and confidence is key, and a recent study looking at the experiences of staff in the North East bears this out.

A University of Durham survey of 3,000 staff at seven trusts concludes that trusts need to develop cultures whereby barriers are recognised and addressed, policies are seen as effective, and each report of bullying is treated seriously. It highlights cultural barriers that stop people reporting bullying; 14% of staff said they did not want to be seen as a troublemaker, while 11% were concerned that this would make the situation worse. A similar proportion of staff said nothing would change and that they would not report a bully who was more senior than them.

NHS Employers will report these findings to employers later this year, along with guidance and best practice. We are keen to support human resources staff and managers to improve their skills and confidence in managing this issue.

It will be difficult to achieve a big cultural shift if organisations and individuals do not have the ambition to support change at all levels. That means clear sign-up and support from boards translated into action by each manager and employee. It needs a shared endeavour.

Fifteen per cent of staff reported in the last NHS staff survey that they had experienced bullying, harassment or abuse from line managers or colleagues. The same number reported bullying, harassment and abuse from patients, their relatives or other members of the public in the previous 12 months.

Bullying can occur anywhere in an organisation so solutions need to be able to reach all parts of it. Where managers and staff work together, the results can be impressive.

An organisation can struggle to tackle bullying if it is rarely reported. Robust staff engagement and encouraging a culture of openness and trust are key in addressing under-reporting. Confidence to report bullying is directly related to confidence to report workplace concerns. The NHS staff survey encouragingly shows that staff now find procedures for reporting concerns to be fairer and more effective.

Trusts are finding diverse ways to achieve this. Luton and Dunstable Hospital Trust serves a community where almost one third of the population are from minority backgrounds. The trust implemented techniques to integrate equality awareness with its work to prevent bullying and harassment. Staff were invited to show their commitment by adding their hand prints to a paper wall in the hospital. Barnsley Hospital Foundation Trust appointed 10 harassment support workers, whose training was provided by a partnership between the hospital, Unison and the Department for Trade and Industry. There is more about these examples at

The benefits to staff and employers of preventing bullying and harassment speak for themselves. The challenge for the NHS is build a cultural shift into transition planning to ensure that the NHS of the future is doing all it can to protect and support its most valuable resource - its staff.


Readers' comments (9)

  • Good luck!!! I have honestly never known a profession like Nursing for the sheer level of bitchiness and bullying!

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  • it doesn't just stop at the hospital ward, bullying online in comments is also offensive and unnecessary.

    what benefits do people get from bullying surely it can't make those who engage in it feel good. isn't life more fun, interesting, rewarding and productive when people are civil and more interactive with one another? if there is a disagreement or the other frustrates can't one first try and tell them gently and make light of it? Doesn't one feel better if one makes somebody else happy or satisfied rather than trying to bring them down. I feel good if I can get somebody to laugh (but hopefully not at my expense although sometimes that is not bad either if you get a laugh from them!)

    I once heard that if somebody finds another boring it is their own fault for not making the effort to find out what the other is interested in and what is interesting about them. we all have at least something in common and boredom lies within and is not the fault of another. True or false?

    Bullying reflects in attitudes towards others including patients and ultimately the quality of care, unless one puts on a false 'have to be nice to patients mask'.

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  • Professionalism within the workplace is NOT what it used to be. The attitude seems to be I know better than you even if they have no idea what your work is, or if you have tried to help an individual with information then they try to to take credit for the work you may have done while trying to 'call you' unprofessionally in front of other staff.
    This I feel should be taken more seriously as the NMC code of conduct is quite clear.
    Those staff who bully in other sectors of the NHS should feel ashamed of themselves the attitude is 'you will do as I say' and 'you are lucky to have a job' are NOT on. People should not be afraid in their workplace and should feel valued and should be treated with respect.

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  • michael stone

    Bullying can be by other clinicians, or by managers, can it not ?
    Back to my 'you need to get 'arms length people' involved very quickly, and that they only need intellignece, not clinical skills, to 'adjudicate' on an issue such as bullying !
    I am with mike and others, about bullying be very unhelpful, and hard to address. Also, managers sometimes use 'bullying' to try and silence people such as consultant doctors who are raising legitimate concerns, by collecting spurious or trivial allegations of bullying against these doctors, and then suspend them accusing them of 'bullying other staff' !

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  • it often appears that those who bully are unaware of, or are in total denial of their poor and unacceptable behaviour, and the effects it has on others.

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  • "The benefits to staff and employers of preventing bullying and harassment speak for themselves."

    This goes for the comments following some of the NT articles too!

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  • Anonymous | 13-Jul-2011 11:28 am

    It is definitely true, that the parties to a disagreement, often will each regard their own behaviour as reasonable, and the other person's behaviour as unreasonable or bullying.

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  • Bullying and hostility will not change in the NHS until there is a cost to that behaviour and incentive to change it. Until there is authentic support for people raising concern or reporting it it will continue and so will its impact on the rest of the team and patients.

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  • michael stone

    Anonymous | 19-Jul-2011 11:19 pm

    Spot on !

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