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Plans to tackle bullying delayed – NHS Highland's health board risks damaging ‘patient confidence’

By Scott Maclennan

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Fiona Hogg.
Fiona Hogg.

Delays to reforms to tackle bullying and harassment of NHS Highland staff is putting “patient confidence” and the health board’s reputation under threat, board members will be told today.

They will hear that the setbacks are so serious that it has been listed on a so-called strategic risk register alongside the pandemic and fire safety.

Related article: NHS Highland set to survey all 10,000 staff attitudes on their views on its “culture” in what will be a major test of its progress towards tackling bullying

It will be confirmed that a culture programme – designed as a response to the bullying saga exposed by whistle-blowers in 2018 – has “slipped with milestones now pushed back”.

The programme came, along with an overhaul of NHS Highland finances, following a Scottish Government intervention.

However, even the finances – which had been performing well recently – have been hit but the delays to the culture programme are not thought to be due to funding.

Among the priorities understood to be behind schedule is an area dubbed people processes, which looks to change how grievances are dealt with.

Another area of concern is that a staff survey to check progress on bullying is not expected to reach everyone because an IT issue left bosses with only half the email addresses of the workforce.

Analysis of whether goals are being met is now expected to be delivered to the board in mid-September instead of this month.

A plan to tackle bullying behaviours, named civility saves lives – designed so the bully is able to change without becoming defensive or feeling attacked – has also been delayed.

Despite an independent review panel finding some managers were incapable or unwilling to address bullying, a new leadership and management development process has started.

NHS Highland’s HR director Fiona Hogg (pictured) hoped strides would be made soon.

“This mainly relates to the scope of the combined culture package taking longer than expected, but which has now been finalised and moved into detailed design and delivery planning,” she said, adding some areas are making progress.

She stressed the importance of “learning and listening” to the staff survey “having taken the time to gather such rich data and insights”.

She added: “We are in the process of a full review of the overall culture plan, priorities and timescales, and will bring this to the September board meeting for review. This replan will also take into account the feedback and actions from the listening and learning survey.”

The delays have prompted its inclusion on the strategic risk register, where the culture programme is graded as at high risk, stating: “There is reputational and workforce risk in relation to the culture of the organisation. This could impact on recruitment, retention and performance, as well as patient confidence in the organisation.”

The register contains only two areas that are deemed at “very high” risk and they are both linked to the burden the pandemic has placed on the NHS – finance and a potential resurgence of Covid infections combined with flu.

The concern is that there will be “poor health outcomes” related to any major rise in Covid infections and the effects of seasonal flu could cause significant disruption to services and the impact of measures to bring them under control.

Further unplanned expenditure and the failure to deliver planned savings due to ongoing financial uncertainties risks hitting targets that could impact its existing £39 million deficit.

Other areas of concern include the potential impact of a cyber incident, given its reliance on technology, plus the age of the workforce combined with recruitment difficulties, and Inverness’s Raigmore Hospital falling behind on building standards related to fire safety.

Work on maternity wards is due this year, but installing sprinklers and other upgrades is slow because it is “paced at the level of disruption the hospital can stand”.

The board will also learn some national targets are unlikely to be met due to the number of constraints posed by Covid measures and forecast winter pressures.

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