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3. As a Head of School or TPD, what can I do?

1. Have belief, get support and give support

2. Understand the unique challenges of your position

3. Practical actions

 

1) Have belief, get support and give support

As a Head of School or Training Programme Director you are in a unique position to influence and empower those involved in training. It can be difficult to know where to start, but have faith that your actions can make a difference.  Here is a real-life story from someone who has been in your position.

Tackling poor workplace behaviour in a deanery is challenging. Seeking advice can help you work through the process, but will also provide you with the support you need.  Examples of those who can help you include fellow HoSs or TPDs, your regional WPB Champion, the RCOG WPB Advisor, your regional HEE quality team and the Director of Medical Education (DME) at the Trust affected.

Those who are subjected to, witness or indeed display poor workplace behaviour often need support too.  You can direct those involved to sources of support and wellbeing resources. Your deanery’s Professional Support Unit (PSU) or Professional support and Wellbeing Unit (PSWU) can be of help with trainees you deem to be in need of additional support.

 

2) Understand the unique challenges of your position

  • The quality of training and trainee wellbeing fall into your domain
  • You receive formal and informal feedback concerning WPB issues which impact on both training quality and trainee wellbeing

But:

  • The individuals involved are often not entirely under your jurisdiction. Rather they are the ‘responsibility’ of the employing trust.
  • Undermining or bullying behaviours may come from non-medical professionals such as midwives, nurses and other allied healthcare professionals, or from doctors outside of O&G.

And:

  • Trainee reporting is often sadly impeded because of fears over negative consequences and career progression following reporting.

 

3) Practical actions

You may wish to gain more detailed information on the issue and you can utilise methods in Question 1 to do this. 

Depending on the nature of the feedback, your initial role will usually be to pass the information onto the relevant department e.g. via the College Tutor or a local workplace behaviour champion.

Depending on the issue, a team approach may be helpful.  Such a team could include your HoS, TPD, local/regional WPB Champions, the unit’s College Tutor and Director of Medical Education, the unit’s Clinical Director and Medical director, Freedom to Speak Up Guardian and trainee representatives. In addition the quality team at Health Education England and the senior HEE team are an important resource particularly in light of adverse GMC / TEF / local trainee surveys.

Below is a sequence outlining a possible approach for managing a report of poor workplace behaviour. It is followed by a table which outlines who, within a hospital, might be useful in tackling the problem according to the job/role of the perpetrator.

 

Sequence of approach for managing poor behaviour

Have belief, get support and give support

Understand the unique challenges of your position

Do you need to gather more information?

Tools to gather more information

Alert the responsible department

e.g. via the college tutor, local WPB champion

The responsible department/trust should take action to address the incident of poor workplace behaviour

For suggested interventions at a department level visit Module 4 "I am responsible for a department that has a problem with bullying or undermining"

Report back on actions taken and progress made or barriers to change.

Assess if the problem has been addressed

You may ask for a report at School Board or set-up a separate time to address the issue.

For persistent issues (or serious issues) consider:

  • Liaising with you regional WPB champion or the WPB advisor
  • Involve your regional HEE Quality Team +/- arrange a school visit if appropriate
  • Are there mechanisms in Module 4 that the department has yet to try?
  • Removing the perpetrator from their educational role
  • Removing trainees from the affected unit, in extreme cases.

 

Useful contacts in tackling poor behaviour

Role of perpetrator

People in the trust/hospital that you can contact

People accessible from within the trust/hospital

Consultant (O&G or other)

 

Midwife

  • College Tutor
  • Local WPB Champion
  • Senior Midwife/Band 7
  • Line manager
  • Human Resources
  • Freedom to Speak up Guardian
 

Nurse, HCA, theatre staff, other MDT member

  • College Tutor
  • Local WPB Champion
  • Line manager
  • Human Resources
  • Freedom to Speak up Guardian
 

Trainee

  • College Tutor
  • Local WPB Champion
  • Educational Supervisor
  • Clinical Director
  • Human Resources
 

You

We recommend visiting Module 3 "I have been accused of bullying or undermining" to guide you