Tag Archives: NHS

Bullying on the increase in NHS (or are people just becoming wimps?)

Kindadukish's Blog - I am not a number, I am a free man (The Prisoner)

One in five NHS workers has been bullied by colleagues: Managers named worst offenders as increasing workloads take their toll.

One in five NHS staff say they have been bullied in the workplace – and managers are the worst offenders.

Almost half said they have witnessed bullying within the NHS in the last six months, according to a new survey.

Among the most common complains were being deliberately ignored and public humiliation by colleagues. Unhealthy environment: One in five NHS staff have been subjected to bullying by a colleague and 43 per cent have witnessed similar behaviour

Almost 3,000 NHS staff took part in the Durham University study, published in the online journal BMJ Open .

One in five of respondents had been bullied by colleagues within the past six months, ranging from rarely to daily. Over 40 per cent had witnessed other staff being bullied at work, at least now and then…

View original post 363 more words


High performing NHS boards

A recent study reported in the HSJ suggests that the best performing boards have a number of things in common.

  • They have had CEOs in post for more than 4 years
  • They have more women on the boards
  • Their non-executive directors (NEDs) contribute more
  • They are probably a specialist or tertiary trust

The study by Manchester Business School looked at published data including board reports and focussed on three factors to identify high-performing organisations.

These were: customer experience, business performance, and employee satisfaction.

They identified organisations which scored in the top 20% in the last two or three years and from those selected the ones which were high performing on at least two of these factors.

NB Only 3 organisations scored high on all three and interestingly none of the Acute Trusts scored high on employee satisfaction.      

 It makes sense that stable leadershipin organisations, particularly in turbulent times, helps them plan strategically and develop a positive organisational culture. Research by Hay shows that leadership style contributes significantly to an organisation’s climate or culture. And Hackman’s research on teams shows that generally speaking (R&D excepted) stable teams perform better as well.


Having more women on boards has been shown to have a positive impact of performance and profit and recent research suggests that women have a constructive influence, probably through their emotional intelligence and social skills, on raising the collective IQ of a team.    

There are obvious problems in this kind of research, as the authors note, but the findings feel intuitively right.

Stress can be a killer for women in high pressure jobs

We are all aware of how stressful work can be at times. Contrary to popular belief not all of it is caused by the deliberate actions of others but usually because of the way we interpret events. Something that is stressful for one person may not be for someone else. Stress can be caused inadvertently by someone lacking social or management skills, and increasingly rudeness at work is being identified as a major cause.

Common sense tells us that rudeness can affect our mood but it also affects our performance, our problem solving ability, and our willingness to work in a collaborative way – and research shows that even witnessing rudeness can create these adverse outcomes and damage the working climate especially in teams that need to collaborate.

Bullying is another source of stress and it might be on the increase again, fuelled by insecurity because of the recession. It also seems that whilst the majority of bullies are men women bullies can be more persistent. There also seem to be gender differences. I’ve found in my work and research that women are more likely to bully using personal attacks whereas men bully under the pretext of performance management.

Now new research has shown that women in high pressure jobs run twice the normal risk of developing heart problems as a direct result of work-related stress. Those reporting work pressure to an excessive degree are also at an increased risk of developing ischaemic heart disease.

The research, published in the Journal of Occupational Health and Environmental Medicine, was based on a 5-year study of over 12,000 Danish nurses aged between 45 and 64. Whilst the link between stress and heart disease is well-established this is one of the first studies on women.


Stressed workers often resort to unhealthy ways of coping such as smoking, eating comfort food, or drinking, which can lead to them becoming overweight and creates a vicious circle. In a study carried out by the author amongst NHS employees nurses had the highest sickness absence rates and also smoked the most. Managers on the other hand rarely took time off but drank more!

A research team at Ohio State University has been studying the effects of stress on health for the last 30 years (psycho-neuro-immunology) and have shown that chronic stress can lead to cardiovascular disease, cancer. stroke, osteoporosis and diabetes. The culprit is stress-induced chronic inflammation as a result of the immune system being in a constant  state of high alert. This in turn wears you down and makes your body less able to fight infections and diseases, heal wounds, and develop antibodies. On a less dramatic level it explains why you can’t shake off that cold or persistent cold-sore when you are stressed.

And the latest research shows that children with difficult childhoods, eg through being abused, are especially susceptible to the physical effects of chronic stress and that their immune systems may learn a hyperactive response to stress which kicks in again when they are facing stressful events as an adult.

The good news is that becoming adept at yoga does lower your stress response.

Updated 2 May 2011: Women with high job strain have a 40% increased risk of cardiovascular (CV) disease compared to those with low job strain, according to research presented at the American Heart Association’s Scientific Sessions 2010. They defined job strain, a form of psychological stress, as having a demanding job, little or no decision-making authority or opportunities to use you creative or individual skills. Their findings were based on a sample of over 17,000 healthy women who participated in the Women’s Health Study. Primarily white health professionals with an average age of 57, they were tracked for 10 years whilst they provided information about job strain and job insecurity.

Job insecurity was associated with risk factors for CV disease such as high blood pressure, increased cholesterol, and excess body weight but not directly associated with heart attacks, strokes and CV death.

The higher CV risks for those who reported high job strain included heart attacks, ischemic strokes, coronary bypass surgery, balloon angioplasty, or death.

The findings that women in jobs with high demand and low control are at risk echo UK research on Civil Servants (The Whitehall studies). The first Whitehall Study compared mortality of people in the highly stratified environment of the British Civil Service over a 10 year period starting in 1967. It showed that among British civil servants, mortality was 3 times higher among those in the lower grade when compared to the higher grade. The more senior one was in the employment hierarchy, the longer one might expect to live compared to people in lower employment grades. It also found higher mortality rates due to all causes but specifically coronary heart disease for men in the lower employment grade when compared to men in higher grades.

Twenty years later, the Whitehall II study, a longitudinal, prospective cohort study of 10,308 women and men, all of whom were employed in the London offices of the British Civil Service at the time they were recruited to the study in 1985, documented a similar gradient in morbidity in women as well as men.  The studies revealed this social gradient for a range of different diseases: heart disease, some cancers, chronic lung disease, gastrointestinal disease, depression, suicide, sickness absence, back pain and general feelings of ill-health.

Leadership pantomime?

A recent article in the Sunday Times asked “what qualities are needed to become an NHS leader” (ie apart from having a skin like a rhinoceros or attracting headlines through being engaged to the NHS Chief Executive)

And if you read as far as the “How to get to the top” bullet points at the end you may despair at the advice to “understand the numerous changes in the last decade“. So if you think it’s sometimes a bit like a pantomime (“Oh no it isn’t!”  I hear you cry).

And staying with the dramatic arts enhancing your  confidence and well-being, are you operating in your first, second or third circle? A top voice coach, Patsy Rodenburg from the Guildhall School of Music and Drama, has written a book on “Power Presentation” which is well worth a read.