Report finds culture of "bullying and harassment" at NHS Lothian

NHS Lothian has a culture of bullying and harassment, failed to accurately record breaches of a waiting time target and does not always properly prioritise patient safety, a review has found.

The Academy of Medical Royal Colleges carried out the review after a whistleblower raised concerns on October about doctoring of patients' waiting times to meet the four-hour target to process A&E patients.

Reviewers found: "Patient safety and quality of care is not always prioritised as it should be, particularly at times of high activity.''

The report agrees with the health board's internal review over recording of breaches of the four-hour target.

Investigators found some staff felt "admonished and blamed'' rather than supported when raising concerns and others reported feeling bullied, harassed and intimidated.

Among a string of recommendations, the report recommends the health board takes urgent action on bullying and harassment, improves governance, ensures a focus on patient care and develops a team approach to the four-hour standard with clear responsibilities.

NHS Lothian has accepted all of the observations and recommendations in the report and said improvement is already underway.

Jim Crombie, NHS Lothian interim chief executive, said: "We have recognised from the outset that mistakes were made and accept the findings of this review.

"It's clear not all was as it should have been. Staff have also come under intense pressure and for these failings I'm really sorry.

"Since the publication of our own review last November we have already taken a number of steps to rectify the reporting errors including significant staff training to ensure correct recording of four-hour breaches.

"We are confident the measures we have already put in place have removed any ambiguity over the correct procedures.

"We welcome today's finding, which accords with our own, that staff had not amended breach times to deliberately falsify performance but instead that confusion had led to these mistakes.''