Guest post by Nan Tewari resident of Brent, and former Commission for Racial Equality officer.
Northwick Park’s maternity unit is once again in the news for all the wrong reasons. One inquiry after another, going back decades - the most recent covering 2002-2005 and 2008 - has recognised ‘poor culture’ as a particular issue. Yet none of these reports has made direct reference to how the absence of good staff management practice (also called human resource management) has adverse impacts on patient safety, patient experience and patient outcomes.
My own experience over a number of years of advocating individual patient cases at the London North West Healthcare Trust, has been one of the same mistakes being repeated with impunity, meaning that the Trust is content to just get by with paying lip service to learning the lessons of incidents. There is a complete lack of will to tackle the underlying systemic issues, relying instead on sticking plaster solutions to cover over the cracks just long enough for the serving senior management incumbents to move on up the NHS greasy pole or collect their pensions.
In the face of the funding and resourcing cuts facing all areas of the public sector, it is unacceptable for staff to have to labour under the added burden of being bullied and racially discriminated against. I have personally witnessed visible minority staff at Northwick Park being spoken down to by white colleagues and having their judgement openly questioned. This means that staff will be reluctant to speak up for patients if they believe those higher up the food chain will hold it against them.
Poor culture arises in any organisation from poor management – at all levels from board downwards. It suggests nothing good of the honesty and transparency of the NHS that enforcement of these tenets is required by Freedom To Speak Up Guardians. It suggests an ingrained penchant for lying that the NHS has to be told it has a ‘duty of candour’, i.e. someone had to actually tell them they need to tell the truth.
BACKGROUND TO BULLYING CULTURE IN NURSING LINK
A bullying culture contributes to a poor nurse work environment, increased risk to patients, lower Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores, and greater nurse turnover, which costs the average hospital $4 million to $7 million a year. Addressing nurse bullying begins with acknowledging the problem, raising awareness, mitigating contributing factors, and creating and enforcing a strong antibullying policy.
PREVIOUS INQUIRIES AT NORTHWICK PARK
Investigation into 10 maternal deaths at, or following delivery at, Northwick Park Hospital, North West London Hospitals NHS Trust, between April 2002 and April 2005 LINK
An independent review of serious untoward incidents and clinical
governance systems within maternity services at Northwick Park Hospital 2008 LINK