Culture of bullying and racial discrimination found at NHS trust

The report stated a number of the bullying cases were directly attributable to racial discrimination

A culture of bullying and racial discrimination has been found at a hospital trust, according to an inspection report.

The Care Quality Commission (CQC) said there was a bullying culture across Nottingham University Hospitals (NUH) Trust, with many staff too frightened to speak up.

The trust has been told it requires improvement as a result of the report.

NUH said it was working to address the concerns.

'Hidden pandemic'

The report said a number of the bullying cases were directly attributable to racial discrimination.

It said the trust's latest staff survey showed the organisation was above average for black, Asian and minority ethnic staff experiencing bullying.

Sarah Dunnett, the CQC's head of hospital inspection, said they were told of bullying incidents that had not been addressed.

"We were concerned about the culture of bullying across the trust with many staff being too frightened to speak up," she said.

She said the CQC would "monitor the service closely" to ensure changes were made.

The report spoke of the trust's directors "working in silo"

Speaking to the BBC, one black staff member said the trust had lost talented staff as a result of its failings.

"There's like a barrier at management level and most of us just can't get through it no matter how good we are," they said.

Another black employee, in her 50s, said: "Many of my fellow black colleagues feel we have been exposed to this 'hidden pandemic' of constant race discrimination.

"If we speak out, we're the problem."

The report highlighted several other areas in which the trust, which runs Nottingham's Queen's Medical Centre (QMC) and City Hospital, needed to make changes.

Inspectors found the board was not working effectively together and had poor relationships, with some executive directors often "working in silo".

A troubled history

The QMC is one of two hospitals run by the trust

• This is not the first time the trust has made headlines for the wrong reasons. Maternity services at both hospitals are set to be the subject of an independent probe after an investigation found dozens of babies have died or been left with serious injuries.

• In December 2020, the CQC rated the units inadequate, criticising staffing and poor leadership.

• In June 2020, Unison raised a group grievance for 36 employees, most of them nurses, on a QMC coronavirus ward who, the union claimed, had been told their "lives would be made hell" if they complained over conditions.

They said some leaders "lacked integrity", focusing on the trust's external reputation rather than addressing challenges.

They also highlighted that many leaders were unaware of issues identified during an inspection of the trust's maternity services, which had existed since 2018.

They warned the trust to improve the quality of its emergency care.

The report said one patient, who had reported to the department with back pain, had remained there for more than 15 hours because the spinal team had refused to accept him.

Staff had spoken of a culture of "patient ping pong" between the emergency team and specialist departments.

As a result of the inspection - which was carried out in June and July and looked at urgent and emergency services and surgery at the QMC and surgery at the City Hospital - the overall rating of the trust has now moved down from "good" to "requires improvement".

Inspectors assessed surgery services at Nottingham's City Hospital

Campaign group Nottingham and Notts Keep Our NHS Public (KONP) said they had previously raised some of the issues highlighted by the CQC with management.

Spokesman Mike Scott said: "While the lack of adequate funding and the resulting staff shortages continues to be a problem, it is clear that there are also serious management issues."

Ms Dunnett said despite the concerns, inspectors saw examples of good practice, such as in surgery services, with high-quality patient care being offered.

The trust was rated outstanding for being caring and the overall rating for surgery remained "good".

Rupert Egginton, deputy chief executive at the trust, said it was focusing on the standard of leadership.

He added: "It's important to note the report does not criticise clinical services.

"[It] recognises the care, dignity, compassion and kindness that our staff provide for our patients.

"But it's our job, as the leaders of the trust, to ensure the foundations of our organisation - our processes, governance, and learning from incidents - improve to allow our teams to provide safe, high-quality care within a positive, open and supportive culture."