The review of Forth Valley Royal Hospital’s frontline operations uncovered a culture of bullying and cover-ups as under pressure staff feared raising concerns.
At a special meeting of NHS Forth Valley Board its chief executive Cathie Cowan described its findings as a distressing read. She told board members that she instigated the independent review after being approach by representatives of Unison and the Royal College of Nurses in November last year.
And she said it was clear from the issues raised that “we had a serious problem” – as the board backed an improvement plan which included recruiting new clinical staff, providing education support and a pledge to fill vacant posts.
Ms Cowan said: “The findings of the review are clearly distressing. The review identified significant issues and behaviours that do not align with NHS Forth Valley’s core values.”
More than half of staff in the emergency department took part in a confidential questionnaire, with almost as many giving individual testimonies about problems in the department.
Staff at the Larbert hospital said they were often reduced to tears and so terrified of victimisation that medical mistakes in patient care were not reported. Many nurses and doctors described themselves as “battle-weary” with concerns over a lack of training for junior workers who were used extensively in A&E, shattering confidence.
An improvement plan, drawn up to take the hospital forward accepted all 45 recommendations from the review as well as adding additional promises to meet issues raised by staff.
It was approved by the board who also noted the findings of the review.
No board member commented on the review’s findings, but chief executive Cathie Cowan and board chair Janie McCusker both acknowledge the distressing contents of the findings and paid tribute to staff for coming forward.
The improvement plan includes moves to recruit additional clinical staff including a new senior clinical nurse manager and additional medical staff.
Education support staff will be brought in to oversee onsite training and all A&E nurses will be given regular protected learning time.
Experienced nurses will also be freed from administrative duties to mentor junior staff with a pledge to increase staff levels 24 hours a day and fill vacant posts.
One of the concerns raised was that junior nursing staff were put on the front door of the emergency department to stream patients away, often to minor injuries or the pharmacy, without a proper clinical assessment so performance targets would improve.
Better leadership and less focus on the department’s patient flow and performance was pledged in the plan.
And the board was told a Speak Up initiative was already being rolled out which follows national whistleblowing standards and would ensure staff felt confident about raising concerns.
Ms McCusker told the board: “While we cannot change what has happened in the past, we can change what happens in the future.
“This is the start of that journey.”
Robert Clark, employee director, thanked the board for responding to the concerns raised by staff representatives.
He added: “I want to thank staff in the emergency department in particular for coming forward with courage, professionalism and dignity.
“The staff organisations are committed to working with the organisation and we are now in the position to come back to you if we feel it (the improvement plan) is not being done.”