Watchdog criticises University Hospitals Birmingham for failing to address bullying concerns
The trust came under review after a junior doctor took her own life in June 2022.
A health watchdog has further criticised one of the country's largest NHS trusts, which has previously been found to have a "toxic culture of bullying", for failing to address staff concerns about "bullying and cronyism".
Rob Behrens, the Parliamentary and Health Service Ombudsman (PHSO), released a patient safety review report into University Hospitals Birmingham NHS Foundation Trust (UHB) in March, describing an "entrenched" and "corrosive" staff culture which could pose a risk to patient safety.
The trust came under review by the Birmingham and Solihull Integrated Care Board (ICB), after a junior doctor at the trust, Dr Vaishnavi Kumar, took her own life in June 2022.
Her father told an inquest that the Queen Elizabeth Hospital, one of four sites run by UHB, was a "hypercritical environment to work in".
The ombudsman said in March that 501 complaints had been received about the Trust since January 2021, as well as multiple instances of avoidable patient death, but the trust had demonstrated a "failure to fully accept or acknowledge" the findings.
Now, after a further Well-Led review, Mr Behrens has highlighted the trust's ongoing "defensive approach when discussing patient safety" as well as its failure to "fully accept or acknowledge the impact of our findings" including in relation to an "avoidable death".
He said: "This is another hard read for the Trust and its service users, confirming what I have been saying about patient and staff welfare and the culture at University Hospitals Birmingham.
"It's a cause of real discomfort to see that staff are still concerned about bullying, cronyism and the dominance of a clinical patriarchy.
"Staff are still concerned about speaking out for fear of repercussions, and the Trust is secretive and defensive. The legacy of defensiveness clearly lives on.
"Ultimately, I want to make sure patient safety incidents are not repeated. We have seen some improvements when working with the Trust, but it isn't enough.
"The Trust has started to acknowledge its failings and says it is aware of the need to accept accountability and learn from its mistakes. It now needs to back the words up with actions.
"There must be significant improvements to its culture and leadership, and, above all, the Trust must listen to the voices of staff and patients. We cannot have more tragedies."
The report says that two female members of staff had come forward with allegations of "sexual harassment and abuse" and during the first phase of the review it had received reports of "significant instances of misogyny".
It added that the inspectors raised concerns of "limited job opportunities" for ethnic and diverse communities as well as for women, and staff had commented on the "whiteness" of the board and senior clinicians.
However, it adds that the "current leadership is proactive in reversing this".
The UHB Trust issued a statement saying that the report said it had shown "good progress" in addressing the previous recommendations, which included Dame Yve Buckland being appointed as permanent chairwoman of the organisation to manage the improvements as well as "resetting the tone of the organisation".
The statement adds that these improvements include "a staff engagement programme meeting regularly, online and face-to-face, with hundreds of staff each week".
David Melbourne, chief executive at NHS Birmingham and Solihull, said: "This follow-up report provides assurance that University Hospitals Birmingham has taken all of the recommendations from the initial review seriously, with good progress having already been made across a number of areas.
"Their improvement journey will be a long one and, while we have seen the beginnings of change, much work is still to be done to create a lasting and different culture across all levels and disciplines, and across all hospital sites."