Bullying risks patient safety

THOUSANDS of doctors across the UK have been victims of bullying or undermining behaviour or have witnessed it in their workplace, new figures have revealed.

The General Medical Council’s 2013 National training survey of over 54,000 doctors in training found more than 13 per cent had been bullied or harassed, almost a fifth (19.5 per cent) had seen someone else being bullied and more than a quarter (26.5 per cent) experienced undermining behaviour from a senior colleague.

These findings support research published in the BMJ earlier this year which suggests bullying remains a "significant but under-reported problem" in the NHS, affecting both medical and dental healthcare professionals.

Bullying creates an unpleasant work environment but, more importantly, MDDUS is aware of instances where it has had a negative impact on patient care and safety.

A key risk area relates to communication between colleagues.

MDDUS medical adviser Dr Barry Parker says: "If there is a breakdown in communication or bad atmosphere between colleagues then it is likely that open communication about patient care will be adversely affected, damaging continuity and the team approach to care that is so important."

In addition, research has shown that being the victim of bullying or undermining behaviour can distract medical or dental team members and draw their attention away from crucial tasks, leading to potentially serious errors. This can pose a particular risk in enclosed areas such as operating theatres or dental surgeries.

Healthcare professionals who do not feel supported at work might also feel less inclined to report and learn from “near misses” or adverse events.

Trainee doctors can be particularly vulnerable in such an environment.

Dr Parker adds: "Aggression or rudeness and bullying behaviour can severely impact on their learning and development. Trainee doctors rely on senior colleagues for support and should feel comfortable seeking their advice. They should also be able to look on their senior colleagues as positive role models."

Bullying behaviour also breaches professional standards guidance set out by the GMC and the General Dental Council and could lead to complaints about a practitioner’s fitness to practise.

The GMC’s Good Medical Practice guidance makes it clear that doctors "must work collaboratively with colleagues, respecting their skills and contributions. You must treat colleagues fairly and with respect and must be aware of how your behaviour may influence others within and outside the team."

The regulator also warns that: "Undermining or bullying behaviour is in total contradiction with these values – it is more than a simple failure to comply. Serious or persistent failure to follow our guidance puts a doctor’s registration at risk."

Similarly, the GDC’s standards guidance on this topic is clear. It states that dentists “must treat colleagues fairly and with respect, in all situations and all forms of interaction and communication. You must not bully, harass, or unfairly discriminate against them.” It adds that dentists “must value and respect the contribution of all team members."

It is important that healthcare professionals with concerns regarding bullying or harassment seek advice before the problem escalates and has a negative impact on their work. In such cases it can be helpful to discuss the matter with a trusted colleague or an MDDUS adviser.

Equally, individuals who are responsible for bullying or harassment are in need of advice and support as this type of behaviour may be symptomatic of issues such as stress or burnout. Those who exhibit such behaviours should also be encouraged to seek help or risk a GMC/GDC complaint that could have serious consequences for their professional practice.

MDDUS is very experienced in helping professionals with health problems that impact upon their fitness to practise. Members with concerns about their behaviour are encouraged to discuss the matter with an MDDUS adviser.

ACTION: Be aware that bullying/harassment creates a poor working environment that can negatively impact on patient safety and care. Seek advice early before the problem escalates.