School bullying, discrimination and shifting when things go wrong are common in the NHS, according to a government-commissioned investigation into the leadership of health services.
But NHS England leaders fear that Sajid Javid will selectively use the report’s findings to paint an unfair picture of senior executives’ behavior.
NHS leaders are particularly concerned that while the Department of Health and Human Services (DHSC) press release on the review cited negative behavior, it did not include a finding of research that is due in part to pressure. exercised over the NHS by politicians.
They are also concerned that the health secretary, in a round of interviews scheduled for Wednesday morning, also highlights the finding of the report of a long-standing “institutional inadequacy” in the way senior executives are trained. NHS.
Tension over the exact contents of the press release sparked backstage fighting on Tuesday. At least two versions of the release came out before it was finally released in the late afternoon. Sources who have seen the report say it greatly praises NHS managers for their hard work, their dedication to improving patient outcomes and the response to the relentless increase in demand for care.
The consultation, conducted by General Sir Gordon Messenger and Professor Linda Pollard, is the largest review of the strengths and weaknesses of NHS management since Roy Griffiths conducted a similar exercise for Norman Fowler, Secretary of Health. of the government of Margaret Thatcher, in 1983.
In a summary of the key findings of the Messenger / Pollard poll in the media, the DHSC said it had “found evidence of poor behavior and attitudes such as discrimination, bullying, and cultures of guilt in certain areas. parts of the health and social care system, with some NHS staff in particular not comfortable speaking. “
However, the DHSC summary did not include any reference to the report’s finding that what NHS leaders have traditionally seen as a political micromanagement of service performance is part of the explanation for this behavior.
NHS trusts in England are often involved in school harassment disputes, either as a result of staff statements, evidence found by the Quality of Care Commission during an inspection, or due to reports of bullying. the “freedom of speech of the guardian” of trust.
For example, there have been recent wholesale changes in the senior management of the Tavistock and Portman health trust in London following a report from their free speech tutor, a separate external review, and school bullying findings. and staff fear of talking about the most recent NHS staff survey.
The DHSC said that while the Health Service Leadership Report “recognized the current pressures facing the workforce and identified many examples of inspirational leadership, it found that, in general, there was a lack of coherence and coordination “. In particular, the DHSC said, “over time, an ‘institutional inadequacy’ has developed in the way leadership and management are formed, developed and valued.”
The report’s findings were “crude,” Javid said. “It shows examples of great leadership, but also where we need to improve urgently. We just have to accept the highest standards in health and care. Culture and leadership can be the difference between life and death. “
In separate statements, Javid told the cabinet on Tuesday that the NHS in England is “a highly successful healthcare system in the Netflix era”. He added that greater use should be made of technology, especially artificial intelligence, to improve productivity, free up time for doctors and address delays in care.