"Toxic culture" concerns remain at University Hospitals Birmingham NHS Trust
The Care Quality Commission has told the trust to make improvements following inspections last year.
The healthcare watchdog has said concerns remain about the culture at University Hospitals Birmingham NHS Foundation Trust, and the way staff are supported.
The Care Quality Commission (CQC) has told the trust to make improvements, following inspections in August and October 2023.
Inspectors found a "worrying number" of staff who felt they couldn't raise concerns without fear of blame or punishment, and others who didn’t feel protected from bullying and harassment.
The inspection was carried out following serious concerns raised in two independent reports, one commissioned by the trust itself, last year.
It found 53% of staff surveyed said they had felt bullied or harassed at work.
Today's inspection report by the CQC has rated University Hospitals Birmingham NHS Foundation Trust as requires improvement overall.
Critical care has declined from outstanding to requires improvement overall and for being well-led. It has dropped from good to requires improvement for being safe.
Charlotte Rudge, CQC deputy director of operations in the Midlands, said: "Our experience tells us that when a trust isn’t well-led, this has an effect on the standard of services being provided to people.
“Over the last year, there had been a number of staff changes at senior level, including a new chief executive, new directors and a number of new non-executive directors. Although there were the beginnings of change and recovery, and recognition of present and past concerns, there had not yet been sufficient time to demonstrate progress and for leaders to show they were dealing with the risks, issues, and challenges in the service and how to resolve them effectively.
"This particularly related to matters of staff safety, unchallenged or hidden bullying cultures, and a fear of speaking up. Throughout the organisation, not all leaders demonstrated they had the skills to be effective leaders and to protect staff from discrimination.
“Although there were genuine efforts to learn and improve, there were still a worrying number of staff across the organisation who felt the trust didn’t have an open culture where they could raise concerns without fear of blame or punishment.
"Also, some staff didn’t feel safe and protected from bullying and harassment, which had a negative effect on their wellbeing. This is completely unacceptable and must be addressed by leaders as a priority to enable staff to feel supported and be able to provide the best possible care to people.
“I want to thank the staff who came forward to give feedback, I know speaking up in these circumstances isn’t easy, but it’s really important because it helps us understand where organisations may need to focus its attention to identify and address any issues."
Trust statement
A statement from Dame Yve Buckland, Chair, and Jonathan Brotherton, Chief Executive, at University Hospitals Birmingham (UHB) said: “We would like to thank the Care Quality Commission (CQC) for their report, which relates to their inspections carried out in August and October 2023.
“The CQC’s findings are very similar to those of the reviews into our organisation, reported throughout 2023, prompting swift action and on-going transformation.
“We are pleased that the CQC’s findings recognise that while improvement is still in its early stages, with good initial work done, the significant change required will take time.
“We believe that the significant changes in our leadership, the new devolved group operating model with local hospital-based leadership and the actions set out in our improvement programme, since the CQC’s visit, evidence our commitment to learning, improving and evolving.
“But we know that culture change cannot be fixed rapidly, or superficially, and that we have a considerable amount of work to do so that the changes are felt by all colleagues.
“To support our incredible colleagues to do their very best for patients, we will continue our unrelenting focus on building a values-led culture and know this will take some time. We will in the meantime continue to address unacceptable behaviours that are not in line with our Trust values of Kind, Connected and Bold, so everyone feels valued and respected for their unique contribution to their service and our organisation.”