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Dignity at work in the NHS

Niladri Konar, Ritika Ghosh Dastidar, Indranil Chakravorty and Neha Shetty
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DOI: https://doi.org/10.7861/fhj.9-2-s12
Future Healthc J July 2022
Niladri Konar
AThe Princess Alexandra Hospital NHS Trust, Harlow, UK
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Ritika Ghosh Dastidar
BRoyal London Hospital, London, UK
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Indranil Chakravorty
CSt Georges University Hospital, London, UK
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Neha Shetty
CSt Georges University Hospital, London, UK
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What is dignity?

Dignity is defined as a personal sense of worth, value, respect, or esteem that is derived from one's humanity and individual social position, as well as being treated respectfully and fairly by others.

The NHS People Plan reminds us to ensure that staff must feel valued, supported and empowered to carry out their work. Therefore, we must address any bullying and create compassionate and inclusive cultures which have implications on staff-health wellbeing, staff engagement and ultimately patient care.

Why are ‘bullying and harassment’ problems?

The 2020 NHS Staff Survey gives employers and national stakeholders invaluable understanding and awareness of the situation faced by the largest workforce in the UK.1

The Francis report highlighted the negative impact of improper working environments on patient safety.2 Higher levels of bullying were linked to psychological distress, intentions to leave the job, self-reported sickness and reduced job satisfaction.3

Kline and Lewis described the cost of bullying and harassment to the NHS as £2.281bn per annum.4 With a decade of underfunding, overt financial pressures, and the economic hit of a global pandemic, it is more important than ever for the NHS to address the associated costs of bullying and harassment.

What can workplaces do to change the culture of bullying and harassment?

Intervention on reports of bullying should take place at the earliest stage to avoid health deterioration in the victims.5 Policies should be easily accessible and applicable to all employees.6 Organisations should ensure there is a Freedom to Speak Up guardian within the system where concerns can be addressed confidentially and with no repercussions.7 Staff need to be supported to ‘whistle-blow’ in order to tackle toxic culture.8

NHS trusts should be forced to publish anonymised data on complaints and independently audited data on key patient safety outcomes and performance indicators.9 Systems should be in place to allow bullying and undermining to be reported without fear of recrimination.10

Purpose and methodology

Our purpose of this study is to find out all the particular qualitative determinants of dignity in the workplace in the NHS.

In the first stage, we looked into all WRES data from all NHS trusts published from 2016 to 2021, to look for top and bottom performers. We enquired whether these organisations have their dignity awareness policies widely available. We looked to see whether there was any corelation. We used statistical analysis to determine the significance.

In the second stage, we will try to get this project accepted by NHS England. We will form a questionnaire to interview relevant people in these trusts. We will require ethical committee clearance and funding by that time to continue the bulk of the project by next year. Initial part is a quantitative policy review. The next part, however, would be a more qualitative one.

Initial results

Initial data show that the better performers have more widely available policies than the under-performers, this may not be the only factor contributing to these performances.

  • © Royal College of Physicians 2022. All rights reserved.

References

  1. ↵
    1. NHS England
    . NHS Staff Survey 2020 National results briefing. NHSE, 2020.
  2. ↵
    1. Francis R.
    Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013.
  3. ↵
    1. Carter M
    , Thompson N, Crampton P, et al. Workplace bullying in the UK NHS: a questionnaire and interview study on prevalence, impact and barriers to reporting. BMJ Open 2013;3:e002628.
    OpenUrlAbstract/FREE Full Text
  4. ↵
    1. Kline R
    , Lewis D. The price of fear: Estimating the financial cost of bullying and harassment to the NHS in England. Public Money Manag 2019;39:166–74.
    OpenUrlCrossRef
  5. ↵
    1. Illing JC
    , Carter M, Thompson MJ, et al. Evidence synthesis on the occurrence, causes, consequences, prevention and management of bullying and harassment behaviours to inform decision making in the NHS. NIHR, 2013.
  6. ↵
    1. Randle J.
    Workplace bullying in the NHS. J Perioper Pract 2011;21:391–4.
    OpenUrlPubMed
  7. ↵
    1. Hughes H.
    Freedom to speak up – the role of freedom to speak up guardians and the National Guardian's Office in England. Future Healthc J 2019;6:186–9.
    OpenUrlPubMed
  8. ↵
    1. Grime P
    , McElvenny DM, Madan I. (2021) Factors associated with sickness absence in a large NHS Trust. Occup Med 2021;71:467–72.
    OpenUrl
  9. ↵
    1. Patrick K
    . Barriers to whistleblowing in the NHS. BMJ 2012;345:e6840.
    OpenUrlFREE Full Text
  10. ↵
    1. Wild JRL
    , Ferguson HJM, McDermott FD, Hornby ST, Gokani VJ. Undermining and bullying in surgical training: A review and recommendations by the Association of Surgeons in Training. Int J Surg 2015;23:S5–S9.
    OpenUrlCrossRefPubMed
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Dignity at work in the NHS
Niladri Konar, Ritika Ghosh Dastidar, Indranil Chakravorty, Neha Shetty
Future Healthc J Jul 2022, 9 (Suppl 2) 12; DOI: 10.7861/fhj.9-2-s12

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Dignity at work in the NHS
Niladri Konar, Ritika Ghosh Dastidar, Indranil Chakravorty, Neha Shetty
Future Healthc J Jul 2022, 9 (Suppl 2) 12; DOI: 10.7861/fhj.9-2-s12
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