Culture of fear still prevalent at Birmingham NHS trust - Bewick

Prof Mike Bewick said changes needed to be made quickly

A culture of fear is still prevalent at one of England's biggest hospital trusts, says the author of a damning review into its culture.

The Bewick report was ordered after a BBC Newsnight investigation into University Hospitals Birmingham found concerns among current and ex staff.

Published on Tuesday, it found cases of bullying and a toxic environment.

Prof Mike Bewick, who headed the report team, told the BBC it was a "fairly sorry tale".

"It is not easy to say these things when you are involved in the health service for 43 years, but I've heard some disturbing stories," he said.

He said "toxic culture was a commonly used term" for people interviewed while working on the report.

The trust is responsible for Queen Elizabeth (QE), Heartlands, Good Hope and Solihull hospitals.

Prof Bewick says the trust is still providing safe care

The report author said there were staff on all four sites who were "delivering their best work".

"I am afraid this culture of fear is still prevalent and people are still reluctant to come forward," he said.

"We haven't found any evidence that the trust is in disarray in terms of clinical safety.

"But this sort of corrosive effect of an environment where people are not free to speak up, or feel not free to speak up... that is backed up by other external evidence.

"This corrosive effect will have an effect on patient safety if things aren't reversed quickly."

Responding to a question from Newsnight about whether patients could rely on the hospital's service, he said: "If it was my family, I would take them to Birmingham.

"There are many problems, and there are some areas where we have indicated that need change fairly rapidly and further investigation. But the overall function and ability of that [trust] to deliver first-class care is very good."

Junior doctor Vaish Kumar left a note blaming her suicide on the QE Hospital, where she worked

Prof Bewick's report also examined how leadership reacted to the death of Dr Vaish Kumar, 35, a junior doctor at the QE Hospital who left a suicide note blaming her death entirely on the place where she worked.

It cited anger from staff that senior leadership did not attend her funeral.

Jonathan Brotherton, the trust's chief executive who took over three months ago, told the BBC it accepted the findings of the report, adding it had already begun to address issues.

Sir Robert Francis, who conducted the landmark report into failings at Mid Staffordshire NHS Trust, told Newsnight the report into the culture at University Hospitals Birmingham showed "clear cause for concern".

The Bewick report is the first of three reviews launched into the UHB trust, which runs Queen Elizabeth Hospital

"The toxic effect of a perception of bullying, harassment and lack of freedom to speak up can be as damaging as its reality, and I sincerely hope that the current leadership of the trust can as a matter of urgency work towards resolving these issues," he said.

"Patients will not be safe in any organisation unless staff feel they will be supported if they speak up about their genuine concerns and will not be singled out for doing so."

Prof Bewick's report, which marks the first phase of his investigation, is one of three major reviews into the trust, commissioned following a series of reports by Newsnight and BBC West Midlands in which current and former staff raised concerns.

The second and third reviews, covering governance and culture at the trust, are expected to be published by June.

• If you've been affected by any of the issues raised in this article, you can visit the BBC's Action Line, or contact the Samaritans