This is one of the recommendations from the ‘strategic’ section of the RCOG/RCM undermining toolkit.
The Francis, Berwick and Illing reports identify a permissive culture in parts of the NHS, which can adversely influence workplace behaviour. Considering leadership and management (section 4.1.4), the Illing report highlights that in such a culture bullying can be used ‘rationally’ to achieve performance targets. It concludes that, if bullying is regarded as rational, interventions will be less effective.
Similarly, work-related stress can be used as an excuse for poor behaviour – a stance that needs to be challenged.
The promotion of a zero tolerance approach stops the rationalisation of bullying and undermining under the pretence of ‘being in the best interest of patients’. This applies to both managers and individual clinicians.
Work-related stress (and non-work-related stress where it impacts on behaviour at work) must be addressed but cannot be used to justify continuing poor behaviour.