You are currently using an unsupported browser which could affect the appearance and functionality of this website. Please consider upgrading to the latest version or using alternatives such as Mozilla Firefox, Google Chrome or Microsoft Edge.

4.4 What can I do to address a problem with poor workplace behaviour in my department?

General approach to tackling issues in your department


  • Be kind – poor behaviours are usually inadvertent and intentional
  • Have empathy – why might this be happening?
  • Be brave and feel assured that addressing the issue is the right thing to do
  • Ask for help and advice 
  • Get to know your local bullying policy
  • Prioritise your wellbeing


  • Do not feel you have to address the issue alone
  • Do not criticise others using hindsight bias (e.g. ‘I would never have done that‘)
  • Avoid gossip
  • Do not shy away from the issue or excuse the issue e.g. “that’s just the way Mr x/Mrs y is and they’ve always behaved like that. They don’t mean it”

Specific advice for:

Problems concerning one or two individuals

The approach to managing a problem with an individual should be to bring about an understanding and a change in behaviour, not to blame and punish.

Infographic: Promoting Professionalism Pyramid

Infographic: Promoting Professionalism Pyramid

Image from the NHS Improvement ‘Civility and Respect Toolkit’:

Problems concerning a particular setting

In the case of a particular setting, it is still important to feedback to the individuals involved, but a wider approach to tackling the issue can also be of benefit.

Situational issues often benefit from a multi-disciplinary and multi-level approach.  They may also be one part of a wider approach to improving departmental culture.


  1. See tips under Module 3, Question 4 "In handover" which include educational videos
  2. Multidisciplinary and multi-level handovers foster a collaborative culture, and help to reduce misunderstanding and misinformation- is there anyone else who should attend handover?
  3. Actively discourage common inadvertent incivilities such as deep sighs and eye-rolling
  4. Thank the departing team
  5. It is usually better to deliver feedback after handover, in private. However, there may be occasional times where the departing team have started an unwise or unsafe plan. Consider ways to address the management safely without undermining them. Phrases such as “Hindsight is a wonderful thing but I wonder if…” or “It sounds like you had an incredibly busy shift. I wonder if you had time to consider this option as an alternative given x…”
  6. Consider displaying which promote a civil and kind handover environment, Poster 5 "Handover" (PDF), Poster 2 "Tea" (PDF), Poster 1 "Sorry" (PDF)


  1. Issues are often best addressed collaboratively (multi-disciplinary and multi-level), proactively gaining feedback from all members of the team.
  2. Explain, acknowledge and agree that poor behaviour leads to increased complications and impaired team performance
  3. Can you use the pre and post list debrief to set the tone and enhance team working? eg discussing training needs of surgeons/anaesthetists/theatre team and which cases are suitable for training, setting realistic time limits so that any change to a senior person is done in a planned way rather than making the “junior” perceive that they have been replaced as they are not “performing well enough”.
  4. Support new team members with scrubbing, preparing patients and familiarise them with both  equipment and processes that are new to them and that the established team may take for granted. Remember team members who are new to the department or to the country will have other valuable skills but may not be familiar with local processes and the local team may underestimate their capabilities as a result. This can cause them to feel undervalued, under-confident and potentially less able to perform well.
  5. Consider displaying promoting teamwork and civility in theatre Poster 3 "Theatre" (PDF), Poster 2 "Tea" (PDF), Poster 1 "Sorry" (PDF)

Problems concerning the wider team/department


What is your department's official stance on workplace culture?

There is a move away from ‘zero-tolerance’ policies and towards creating cultures of civility, respect and kindness.1  Misunderstandings will occur, but in the right environment these misunderstandings are addressed early, are less likely to escalate or to spread.

Make the department's stance visible

Make sure everyone who works in your department is aware of the departments stance on workplace culture.  Some examples of how you might do this include through departmental activities, induction for those new to the department and posters (RCOG posters below, CSL infographics, gathering of kindness posters)

Lead from the front

Show that you believe in civility, respect and kindness.  This can be easier said than done and takes courage.

  • Show that it is ok to speak up by letting your colleagues know if you witness incivility or poor workplace behaviour.  Train in 'calling it out'.
  • Show that everyone can be inadvertently rude or misunderstood by thanking those who spot your own inadvertent uncivil behaviours.
  • Show that it is ok to say ‘sorry’ when it happens.

Compassionate Leadership

  • The King’s Fund have worked well with NHS Improvement to develop compassionate leadership resources. They describe 4 key behaviours: attending, understanding, empathising and helping.
  • Practical advice for embedding compassionate leadership can be found in Vogus and McCeleenad’s “Actions, style and practices: how leaders ensure compassionate care delivery” BMJ Leader June 2020
  • There is increasing evidence that those working in care- giving organisations which are compassionate are more likely to have the emotional resource needed for caring and are less likely to experience burnout. (Figley 1995, Lilius et al 2011)
  • Optimism, cohesiveness, humour, support and a sense of efficacy in work contribute to improved patient care (West 2013). There is an unassailable link between patients who are treated with compassion and employees who are treated with compassion.



Happy and healthy staff are more likely to be kind and civil at work.  Therefore staff wellbeing is always important.  If your department has problems with poor workplace culture or behaviours then your staff may be in particular need of support.

  • How do your staff know that you really believe staff wellbeing is important?
  • What more could your department do to show support for your staff’s wellbeing? 

The answer to these questions will depend on your own department but could include:

  • ensuring that there is an enjoyable rest space with refreshments
  • encouraging staff to take breaks
  • supporting wellbeing after adverse events such as team debriefs and ensuring tutors/supervisors/mentors are aware of members of staff involved in adverse events so that they can provide ongoing support
  • Hosting Schwartz rounds
  • Ensure that staff members have appropriate supported “Return to Work” after prolonged absence eg sickness, shielding or parental leave.

See more general resources you can signpost individual staff towards


Strengthening team relationships both within and between disciplines is invaluable.

Below we give some examples of strategies to enhance team working. These are designed as a taster to get your started. The list is by no means exhaustive and there are many other excellent examples.

Multidisciplinary working

  • Ensuring emergency skills/drills or simulations and teaching is multidisciplinary
  • Ensuring multidisciplinary representation at handovers
  • Multidisciplinary debriefing e.g. after stressful events, can help build positive relations between individuals and the team as a whole. You could consider using appreciative. Read more about appreciative inquiry (PDF) or watch an introductory video
  • Adopting a multidisciplinary approach to team level interventions in general e.g. if you are introducing workplace behaviour champions then have champions across the disciplines, if you are running a human factors session then open it up to staff across disciplines
  • Consider multidisciplinary mentorship eg senior midwifery mentorship of most junior medical team members/those new to the department to help foster understanding of each others’ perspectives and work challenges whilst allowing a “safe space” to ask questions.

Improving understanding of self and of others, particularly under stress:

Celebrate your team and its diversity

Help new team members integrate

  • After working in a department for a while you can begin to take for granted all of the subtle cultural knowledge that you have accumulated, especially around departmental processes and guidelines.
  • Remember that when new members join your team from outside of this culture, they are trying to learn these new cultural norms alongside doing their day-job and may fear asking for help as they may fear that they will be perceived as not being able to manage if they do so.
  • During this period of adjustment acknowledging this and supporting them develops feelings of inclusion and value.
  • Get to know those who are new to your team; where have they come from, what is their background and do they have any specific needs? Do they have any support networks locally?
  • Doctors (and other healthcare professionals) new to the UK have the additional challenge of adjusting to UK culture and the NHS. They may require support with practical challenges such as registering with a bank and securing housing which need to be addressed within normal working hours and yet they may have started work almost immediately after arriving in the area and may feel worried about asking for time to arrange this. There have been examples of people not being able to be paid as they have not been able to arrange a bank account. Take time - whilst being respectful of their privacy – to ensure they have practicalities such as housing/banking/medical cover arranged. You may be able to support them by facilitating leave to do so.
  • Consider supporting new team members with periods of shadowing, mentors, tailored induction and signposting support available.
  • An RCOG eLearning module for "Doctors new to the UK" is in development (as of May 2021)
  • Engage in supported Return to Work for the returning after a prolonged period of absence from usual clinical duties eg parental leave, return from shielding or sick leave. Acknowledge how people may feel apprehensive returning from prolonged periods of absence.

Team education

You could consider ways to encourage individual team members to gain self-awareness and understanding of how they function within a team.

 These are some examples of methods:

These need to be done with support for the individuals and the ability of skilled team members to provide constructive feedback.

There are many free resources on team performance as well as commercial enterprises.  The RCOG does not endorse any particular provider or method.

  • Practice gratitudes: Simply remembering to say please and thank you, in person e.g. at the end of a clinic/list/shift, on the phone and in emails can lift the mood and improve communication within the department.
  • Develop a ‘Greatix’ Board: Where positive achievements within the dept are shared e.g. thank you cards, notes on individuals or teams that have performed well e.g. managing a shoulder dystocia
  • Promote kindness: The Gathering of Kindness aims to build, nurture and instil a culture of kindness throughout the healthcare system.  They have a useful toolkit and posters.
  • A ‘Positive Mindset Board: A daily or weekly message can be placed in a position of prominence to highlight a positive message for all staff for the following day or week – this could also be discussed at handovers e.g. on Labour Ward
  • Promote learning from things that go well e.g. Learning from Excellence: resources, community
  • Use excellence reporting systems: Enable all staff within the organisation to report good and excellent practice that they experience via a quick and simple form. Here is an explanation from Learning from Excellence (PDF) and video
  • Introduce appreciative Inquiry: Asking positively framed questions (inquiring) about a particular topic, in order to increase the value of that topic (appreciate).  Read more about it (PDF) and watch an introductory video
  • Awards: Creating departmental awards or proactive use of trust awards can show appreciation of excellence e.g the Going the Extra Mile (GEM) award

Infographic: "Thank you" 2 words, huge impact

Infographic by Civility Saves Lives: "Thank you", 2 words, huge impact

See these and more infographics by Civility Saves Lives at

See this and more infographics by Civility Saves Lives at

Misunderstandings and poor behaviour, which are managed well and resolved fairly, are part of what makes a supportive and positive department.

There is a move away from ‘zero-tolerance’ policies and towards creating cultures of civility, respect and kindness.1

Misunderstandings will occur, but in the right environment these misunderstandings are addressed early, are less likely to escalate or to spread.

The aim is to make it routine and safe for staff to talk about issues with workplace behaviour.  This requires psychological safety in the workplace or ‘permission for candour’.

It is helpful to remember that most incidences are unintentional and that speaking up will help your team be the best version of themselves.

Examples of just a few of the ways you can ‘make it OK to call it out’ include:



1. (PDF)


Some of your team will already be strong believers in the importance of a positive workplace culture.

They can be excellent advocates for the cause and help deliver the departments agenda.

Others may not see the value and may question "why we are thanking people for doing their job?".

Persevere – it will take time to change situations but it can be done, and has been.

Consider recruiting a diverse team including junior doctors (trainees and non-trainees), consultants, midwives, students and supervisors/managers into advocacy roles, e.g.:

  • Workplace behaviour champions
  • Civility champions
  • Anti-bullying team
  • Positive Working Group-an impartial group to address departmental issues (not just workplace behaviour issues)

Much of the power of these teams comes from their collaborative nature and it is important to ensure representation across your department.

Key NHS resources and references

NHS resources

Other key resources