A "worrying picture" of bullying exists at the Care Quality Commission (CQC), the UK health regulator, according to a new report. Of some 236 employees at the CQC who took part in a survey, 92% reported having been subjected to bullying behaviours, adding that bullying and harassment in the workplace was "a problem."
The CQC is the official overseer for inspections of dentists, GP practices, care homes, and hospitals.
According to People Opportunities Limited, the consultancy that carried out the report, the problem of bullying exist right across the organisation and at all levels.
The £54,000 report comes a month after the CQC was severely criticized for covering up its failure to identify serious problems at Morecambe Bay hospitals where 16 babies died as a result of neglect.
The report was commissioned by the new Chief Executive of CQC, Davis Behan, who wanted to give staff the opportunity to air their grievances and find out how serious the problems were.
The authors explained that although the reports of bullying and harassment in the workplace cannot be formally substantiated "they do contribute to a worrying picture of the perceptions of a significant number of staff. This impacts performance and needs paying attention to."
The report added that the majority of those interviewed asked for complete anonymity and did not want to disclose exactly where in the CQC they worked or what their function was.
The authors concluded that there is a "significant disconnect" between several managers and staff who were interviewed. Managers did not appear to work in a team spirit with their staff, and spent very little time with them. "Many of the staff we spoke to did not see their line manager as a member of their team."
Although bullying appears to be widespread within the CQC, the report noted that there is clear evidence that people throughout the whole organisation want to eradicate it, and have to capability to do so.
Bullying blamed on reorganisations and workload
The authors wrote:
"We suggest that the manifestations of bullying are systemic and largely the result of the number of reorganisations that the CQC has gone through whilst being expected to deliver an increasing workload."
Many CQC staff members who were sent to inspect hospitals for abuse and neglect said they were "overwhelmed by work" and caught up in a blame game and destructive behaviour of their managers.
The report stresses that the focus should be on creating a more productive working culture rather than the labeling of bullies.
The CQC has a history of bullying, harassing and gagging former inspectors who had exposed its incompetence. Whistleblowing CQC board member Kay Sheldon tried to warn that the organisation's incompetence was putting patients in danger. Dame Jo Williams, who was chairman of the CQC at the time, is alleged to have commissioned a mental health assessment of Sheldon using public money in her attempts to get her suspended.
In an interview with The Guardian, Sheldon explained that the monumental task of merging three organisations into one and creating the CQC was a problem from the start. Sheldon said "There was huge pressure. I think the organisation never really got over that. But for whatever reason, the organisation and the Department of Health were not really willing to face up to the fact that the CQC was struggling quite badly."
Before March 31st, 2009, the health and adult social care regulators in England consisted of three bodies:
- The Healthcare Commission
- The Commission for Social Care Inspection
- The Mental Health Act Commission
The three were merged into one after the Health and Social Care Act 2008. The Care Quality Commission was formed, and began operating on April 1st, 2009.
Sheldon added that criticism, rather than seen as a means for improvement, was frowned upon and perceived as disloyalty. "It was a failure of leadership. The executive team and board did not have the capability to turn it around. We had a board that was overly sympathetic and advising rather than governing and an executive team that was struggling. Their response was to try to get to grip with the situation. That led to a culture that many staff felt was oppressive and there were many reports of bullying, related to when staff raised concerns about workload and their ability to do the job. They were effectively told if you can't take the heat, get out of the kitchen."
Sheldon complained to an employment tribunal and was awarded £60,000 compensation.
Some comments made by CQC staff to the authors of the report:
On page 13 and 14 of the report the authors listed examples of comments made by CQC staff. Below are some of them:
- Bullying of new employees coming in from senior professional backgrounds - people who had chosen to leave more highly paid positions because they strongly believed in the vision and purpose of the CQC - were commonly bullied and let down when joining the CQC.
An ex-Sister was told when she was trying to understand how things worked and was seeking to do her very best "You're not a Sister now - just get on with it and don't come to me with questions - you should know this." The problem was that if one was not told clearly what to do and mistakes were made, there was absolutely no back-up from managers. They would be criticized severely.
- "He's never been on an inspection with me - I don't even know if he has ever done one".
- "I've moved teams and the way reports are written is very different - when I asked my line manager to help me she told me to look in the guidance. I pointed out that what she was asking for was different to the guidelines and she went ballistic. She shouted "You're not in charge now" No-one has ever spoken to me like that."
- "My report was sitting there covered in red pen - I was terrified." This was during a team meeting.
- Reports got changed and changed, and then the changes were changed again. When a comment was made about this, the person was accused of being useless at writing reports.
- "Managers need to support you, not just tell you off all the time."
- "My manager shouted at me, right in my face, in front of the team. After the meeting she apologised. I was off sick for 6 weeks"
- "In front of the team he suggested I went to the gym or bought a bike so I could lose weight. I was deeply shocked and humiliated."
- Several comments of workers having their competence questioned, which for many was a new experience.
- "I'd only just come thorough induction and she kept asking me how many inspections I would do in a week. I was crying at work and at home - my team members were appalled at my treatment."
The authors wrote "It is important to recognize that the targets are more likely to be a symptom rather than the cause of perceptions of bullying. In fact, everybody we interviewed accepted the need for targets. Their issue was to do with how these were communicated and managed."
- "I have 20 years of NHS experience and I'm the only one in the team who doesn't have an NHS trust. I asked her if I could get more involved with NHS and she gave a trust to a new member of the team who has no experience at all. She undermines me all the time."
- "It's a numbers game - they don't want us to use our experience and feel threatened by it."
- There was a culture of blame and everybody dreaded making mistakes.
The Daily Mail quotes Matthew Sinclair, of the TaxPayers' Alliance, who said "The CQC appears not only to have let down the patients it was charged with protecting, but also the commission's own staff. No wonder it was unable to expose failings within the NHS when it presided over its own culture of bullying and poor management. The organisation urgently needs to show it provides value for taxpayers' money if it is to retain the faith of the people picking up its bills."
Kay Sheldon reappointed to CQC board
On July 2nd, 2013, the Care Quality Commission announced that Jeremy Hunt, Secretary of State for Health, agreed CQC's request that Kay Sheldon's tenure on the board of CQC should continue when her current term ends in November, 2013.
David Prior, Chairman of CQC, said:
"One of the great lessons that has come out of the catastrophic failures in care at Mid Staffordshire and University Hospitals Morecambe Bay can be summed up in one word: humility.
It has taken the courage and determination of men and women like Kay Sheldon, James Titcombe and Julie Bailey to shine a light into parts of the NHS which have hitherto been shrouded in secrecy. It is these individuals, not the great institutions of the NHS or government that have achieved this.
I hope Kay's reappointment will give a clear message that we in the CQC are unequivocally on the side of the patient and believe deeply in the importance of openness, honesty and transparency."