The Royal College of Obstetricians and Gynaecologists (RCOG) has undertaken the first investigation into incidents of bullying and undermining among obstetrics and gynaecology (O&G) consultants in the UK.
The study, published last week in BMJ Open, involved 664 consultants who took part in a survey in 2014. It showed that 44% (290) of those who responded had been persistently bullied or undermined. This represents 14% of the consultant workforce.
The types of behaviours most reported were persistent attempts to belittle and undermine an individual’s work; undermining an individual’s integrity; persistent and unjustified criticism and monitoring of work; freezing out, ignoring or excluding and continual undervaluing of an individual’s effort.
Victims report that those senior or at least close in the hierarchy such as lead clinicians, medical directors and board level executives carry out most bullying and undermining.
Two thirds of consultants identifying themselves as victims of bullying and undermining suffer major or moderate effects, the survey also found. This could range from taking sick leave to moving position, depression and reduced confidence. When asked if the problem was being addressed, 73% of those who answered this question stated that it was not.
Study co-author, Dr Joanna Mountfield, Consultant Obstetrician and chair of RCOG’s Specialty Education Advisory Committee, said:
“This is the first study looking at this issue at a senior level and it provides us with a more holistic view of the situation. We recognise that as the survey was self-selecting the sample may over represent the proportion of victims and those who have encountered bullying and undermining may have been more likely to take part. Despite this, the results still represent a significant segment of the RCOG membership who need more support and we should acknowledge and address the scale of the problem in all grades of staff.
“The RCOG has already undertaken much work to tackle this problem. Together with the Royal College of Midwives we have developed a bullying and undermining toolkit with practical advice and examples of the action doctors and midwives should take when they encounter unacceptable behaviour in the workplace. We have also developed an e-Learning resource to help health professionals from all backgrounds improve how they deal with colleagues, provide feedback, and respect cultural differences.
“Additionally, Workplace Behaviour Champions have been established in every Local Education and Training Board/Deanery to offer informal support to trainees if they run into problems and we are now considering extending this support to consultants and other career grade staff.
“We are encouraged to learn that when action has been taken to tackle undermining and bullying in units with supportive management, positive change has been achieved. However the findings of this survey suggest much more needs to be done both locally and nationally including an overhaul of the current reporting and investigation processes within Trusts.
“This data is congruent with the reported rates of bullying and undermining in the NHS staff survey and suggests we are not the only speciality dealing with these issues. Lord Carter‘s recent report also recommended Trust Chief Executives lead work on reducing the incidence of this behaviour in their organisations.”
Study co-author and Vice-chair of the RCOG Trainees Committee, Dr William Parry-Smith, said:
‘’It is essential that undermining and bullying behaviours be regarded as an issue for all those working in the NHS. We must recognise that the data shows that consultants also require help, guidance and support as much as their junior doctor colleagues, to deal with poor workplace culture.‘’
Professor Clare McKenzie, RCOG Vice President for Education, added:
“Undermining and bullying behaviour is unacceptable in any workplace, but in our profession it can have devastating effects on patient outcomes, as well for the individuals concerned. This is both an individual clinician and patient safety issue.
“Reducing undermining and bullying behaviours will require cultural change through good leadership and opening channels of communication between disciplines, professions and managers so issues can be addressed. Fundamentally, unacceptable behaviour must be addressed more effectively by individual organisations at a senior Trust management level. The RCOG believes that we all have an individual responsibility to treat all staff in the same way as we wish to be treated ourselves.”
Notes to editors:
For media enquiries please contact the RCOG press office on 020 7772 6300 or email firstname.lastname@example.org
Tariq Shabazz et al. Consultants as victims of bullying and undermining: a survey of Royal College of Obstetricians and Gynaecologists consultant experiences. BMJ Open 2016.
See Lord Carter's independent review of productivity in hospitals – February 2016.
Read the RCOG/Royal College of Midwives updated joint statement on undermining and bullying in the workplace – October 2015.
Find out more about the RCOG/RCM undermining toolkit and RCOG’s e-learning resource, designed to help doctors tackle undermining and bullying behaviour in obstetrics and gynaecology units. The e-learning resource is now freely available to all health professionals across the NHS.
About the Royal College of Obstetricians and Gynaecologists (RCOG)
The RCOG is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. For more information, visit our website or follow us on Twitter @RCObsGyn.