Bullying probe at Forth Valley Royal Hospital emergency department

The claims, first raised by the UNISON union’s Forth Valley Health branch and the Royal College of Nursing (RCN) last year, resulted in an independent investigation which produced 45 “wide-ranging recommendations” on ways of improving governance at the Larbert facility.

However, it’s also emerged bosses were made aware in 2018 of a hostile working environment at the hospital’s A&E department.

At the time, it was visited by Scotland’s then chief medical officer, Catherine Calderwood, who was informed of conflict between doctors and leading nurses.

Ms Calderwood recommended FVRH chiefs take note of other hospitals’ ways of operating and staff support methods, yet the dispute was not resolved by NHS Forth Valley (FV).

The local health board said ­Calderwood attended FVRH in October 2018 when she “put forward a small number of recommendations which were fully addressed at that time”.

However, a review this week revealed tensions were so high they caused an “irretrievable breakdown of necessary working ­relationships”.

The news comes just days after FVRH celebrated its tenth anniversary.

The review said the bullying and intimidation of staff took place over a “prolonged period”, with employees claiming the problems originated years ago.

How nursing staff were treated was among the main issues flagged up to those involved in the probe, however, complaints regarding doctors feeling intimidated were also made.

The investigation – commissioned by Cathie Cowan, chief executive at NHS Forth Valley when staff representatives escalated the matter – advised strengthening leadership, reviewing staffing, looking at leadership and learning and improving relationships.

The report also made several recommendations in relation to workforce and clinical, corporate and staff governance.

The courage of those who shared their concerns has been commended by UNISON after the review revealed patients were put at risk by the working culture of the department.

Karren Morrison, UNISON Forth Valley Health branch secretary, said: “The report into culture and governance in the emergency department at Forth Valley Royal Hospital has now been published and has made 45 wide-ranging recommendations which do not only relate to the emergency department but to the governance process for the whole organisation from the board down.

“I would like to commend our members for their bravery for coming forward to raise their concerns to us in the first instance and to the staff who engaged with the review process which has enabled such a comprehensive understanding of the situation.

“UNISON is grateful for the prompt action of the chief executive and to the review team for the comprehensive work that has been done in producing the report. We have been given assurance from both the chief executive and the chair of the board that all recommendations will be implemented in full.

“While we are satisfied with the process to date, our job now is to ensure NHS Forth Valley swiftly and effectively implements the recommendations from the report.

“UNISON and the staff side will continue to engage in partnership working with the organisation to ensure this happens. UNISON will continue scrutinise the actions taken by NHS Forth Valley, compelling it to meet the report recommendations in full.

“We would urge the organisation to prioritise any recommendations that ensure a safe working environment in the emergency department for our staff.

“As a trade union, UNISON is keen to work with the organisation in partnership to aid in the implementation of the recommendations.”

Ms Cowan, said: “We have a duty to ensure the health and well-being of local staff as well as the patients they look after.

“It is important that any concerns raised by staff or their representatives are taken very seriously and fully explored in a fair and open way.

“That is why as soon as these concerns were raised, I asked a team of experienced external healthcare professionals to carry out an independent review of the culture and governance arrangements within our emergency department.

“I would like to personally thank all of the staff who participated in the review process for sharing their experiences, providing feedback and, in many cases, putting forward their own ideas and suggestions for improvements.”

Bob McGlashan, senior RCN officer, said: “RCN members came to us with a number of very serious concerns, including unsafe practices and a culture of intimidation in the emergency department at Forth Valley Royal Hospital.

“We wrote to the health board about these issues in November 2020 and they rightly acted quickly to set up an independent review.

“Staff across the NHS and social care are working under incredible pressure at the moment and it is completely unacceptable for anyone to be subject to bullying or any other form of intimidation.

“We look forward to working with our members and NHS Forth Valley to implement these recommendations in full to ensure nursing staff feel safe and are able to provide high quality patient care.”

A new sub-committee, led by Janie McCusker, NHS FV chairwoman has been set up to oversee the review recommendations and meet with local staff to discuss these and identify any additional actions the workforce would like to see within the emergency department.

A spokeswoman said: “A number of wider governance-related issues were also highlighted during the review, many of which are already being addressed.

“Others relate to work which was paused due to the Covid-19 pandemic and are now being implemented as part of local remobilisation plans.”

Michelle Thomson, Falkirk East SNP MSP, said: “I thank the staff and UNISON Forth Valley Health for bringing forward these issues.

“I am pleased to note that the CEO of NHS Forth Valley has acted so speedily to produce this report with a range of recommendations. I look forward to engaging with them regularly as they seek to implement them.

“Good governance, although a dry subject, is important as it underpins the culture of any organisation.”

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