Saturday, 10 February 2018

Scapegoating staff after critical incidents

Poor Dr Bawa-Garba struck off by her own professional body that has not a clue about working conditions in the NHS nor the implications of their action that sounded so vindictive.  What did they hope to achieve by it?  The fallout from their action, wasting doctors’ money going to the High Court to have the verdict of the Medical Practitioners Tribunal overturned, raised all sorts of questions about them and for practitioners too.  

Jenni Middleton, Editor of the Nursing Times ( has commented on her article for On the pulse this week that nurse Isabel Amaro, was also convicted of manslaughter by gross negligence for her part  and struck off by the Nursing and Midwifery Council in 2016 .  

Ironically, the trust involved, has since made changes to their systems to prevent a re-occurrence of such a tragedy.  In other words the doctor and the nurse’s claims about many failings that day were justified.  Oh the injustice of it all.  

The Secret Barrister has written a very insightful article about the doctor’s case and the safety of having lay people decide complex situations about which they know very little or nothing at all, for example, the way junior doctors are expected to cover large caseloads. 

This is not far removed from nurses being in a similar situation, having to care for a high number of sick people with very few staff, often covering extra shifts as well as working long hours.  Many leave their shifts in distress because they just could not physically meet the demands being made on them.  How can this ever be safe for patients and staff alike?
Scapegoating is alive and well according to people who contact the website .   What is so frustrating is that someone is seriously injured by the action taken against them – psychologically, physically, emotionally, financially.  In every way you can think of, that person is harmed.   Sometimes the harm is irreversible.  The harm to their families is immense too.   Anecdotally, relationship break up is common.

I hate to think how Dr Bawa-Garba is feeling now or poor Nurse Omara.  Maybe if their names had been double barrelled English names they might have suffered a lesser fate or even have been spared all this terrible action against them?  (The doctor was initially informed by the CPS in 2012 that she would not be prosecuted at all.  I don’t know about the nurse.)  

Consider the time all this has taken, from 2011 till 2016 for the nurse to have her career ended and now for the doctor.  What a toll it must have taken on these poor people and their families and friends.  

A frequent complaint against the NMC by staff who are unnecessarily or unjustly reported to them is that they suffer long periods of time before they discover their fate too.  Even worse, many feel they were presumed guilty until they could prove their innocence.   

What a mess.  

Tuesday, 7 November 2017

Light at the end of the tunnel: re-thinking disciplinary action in the NHS

At present a manager informs HR that s/he is planning to suspend a member of staff for what they claim is gross misconduct.  The HR manager presumably checks that what is being alleged, is actually gross misconduct (though there is no evidence that I know, to suggest that) and then the awful process unfolds.  The worst case scenario is that the innocent victim is called to a meeting with their manager, without knowing what the meeting is about – congratulations for their hard work in very difficult circumstances maybe? 

What follows puts them into a state of shock and the direction is now downhill all the way – vague allegations, exclusion from the work premises (with the embarrassment of being marched off in many cases), long delays, no fairness or transparency in the process and finally some punitive outcome.

Patient care suffers – one less member of staff, other staff demoralised by their colleague’s disappearance, vague rumours. 

BUT there is hope.  A few managers are stopping this awful waste of staff and time.  Roger Kline, Research Fellow in Middlesex University Business School, has described the different approach in his seminal work, re-thinking disciplinary action in the NHS.  See .  See also for more examples of different approaches summarised by Roger  (pp 110-143).

At last some trusts are recognising that the disciplinary route is usually not appropriate or even necessary (though sometimes it is of course), that preliminary investigations need to be more robust and that most often, any clinical ‘never or near miss’ events have a strong element of systems failure when root cause analysis is used.

Using the Incident Decision Tree series of questions as an initial guide helps to clarify the issues and the course of action needed. 

The new processes move away from the destructive and futile culture of blame which usually fails to achieve a single positive outcome.  Looking at the possibility that there has been systems failure, using root cause analysis, any critical incidents are dealt with in a constructive manner and ‘lessons truly are learnt’ as trusts like to say, when it usually means quite the opposite under the present system.

These new approaches may also prevent unnecessary formal disciplinary procedures where unsubstantiated allegations have been made because of personality clashes, or worse still, bullying behaviour by inept, incompetent even possibly psychopathic managers.  The damage to people’s health, relationships and career to name just a few outcomes of the destructive nature of suspension and all that follows, is immense.  Employees disappear into the NHS ‘Black hole’ a place  little recognised by the public till recently, thanks to the high profile whistleblowers and the reporting of the often illegal actions taken against them to silence them.

What now needs to happen is that these improvements are rolled out throughout the NHS and made mandatory, with reports to a central agent to identify where there are problems in an organisation.

What a hope and what a difference it would make.  Thank you Roger.
Julie Fagan  

Wednesday, 20 September 2017

Dysfunctional NHS managers with narcissistic or psychopathic personality disorders

A contact recently sent me an article about people with narcissistic personality disorders.  If you enter those words into your search engine, several articles will appear giving the same information.  Most of it is copyright.  It was new information to me. 

There is some work on the difference between psychopaths and narcissists on line too.  One writer says not to worry about the label, just avoid becoming a victim.  That is all very well in personal relationships if you can get away from them, but very different if you have to work with them. 

Signs of serious problems will be the number of staff who leave.  Another sign is the number of staff who are being suspended, a very effective way of destroying an innocent person who dares to complain.  My strong advice in those situations is to leave.  If you read the stories on the  website and see what power and harm these people can do, you will understand why I write that.

Why do organisations fail to recognise this obvious sign and continue to support the perpetrator, unless of course the whole culture is one of bullying by the management team including the person at the helm, the chief executive?

If you are or have suffered at the hands of a malfunctioning manager/team leader/ work colleague, who is unbelievably bullying and manipulative the information is very relevant.  The signs of these disorders are very clear by the way they behave.  For example, they never apologise and never take responsibility for their actions.  It will be yours or someone else’s fault.  

They lack empathy.  They really don’t care.  For narcissists, the theory is that the person is deeply hurt from childhood and cannot face dealing with the hurt.  For the psychopath, there is no obvious reason why they lack emotional intelligence. 

I feel sad for these people.  Treatment is not easy or obvious and if they don’t realise they have a problem, then the future looks bleak.

I feel alarm for their victims because the perpetrators are so powerful within the structures of the NHS due to the absence of accountability, the anonymity of the people working in the organisations and the perpetual culture of blame that encourages this type of behaviour. And the Department of Health has too many problems to deal with this one even if it wanted to it seems inspite of the huge costs.  How will it ever change?

If you have any ideas please email me at Thank you

Thursday, 27 July 2017

Failing trusts but what about failing leaders of failing trusts?

Failing trusts but what about failing leaders of failing trusts?

In April this year, ITV News reported that Northern Lincolnshire and Goole NHS Foundation Trust was to become the first trust in the country to re-enter a failure regime after inspectors found that patient safety and quality of care had "deteriorated". 

"Having seen improvements to patient care previously, we are disappointed that our latest inspection of Northern Lincolnshire and Goole NHS Foundation Trust found these improvements had not been sustained and there had been an overall deterioration in quality and patient safety. We will continue to monitor the trust and will return to check on the progress it must make. NHS Improvement will be working closely with the trust to ensure full support is available to make the improvements needed."
– Ellen Armistead, Care Quality Commission

Clearly something was going very wrong there but  at a public consultation held at Grimsby Town Hall, hosted by Northern Lincolnshire and Goole NHS Trust (Nlag), aimed at updating local people on the progress Nlag is making to be removed from special measures the trust chairperson insisted that things were improving.

If that is so, then why had a senior manager felt the need to write anonymously to the local MPs stating that
"It is with sadness and regret that I find myself in the invidious position of having to write to you anonymously regarding the leadership and general direction of travel for the above organisation.
I do not feel able to identify myself and despite having held a senior position in the organisation for many years I feel the time has come for me to share my concerns.
Despite the CQC having recently visited us, I don’t feel that culture and general leadership have been addressed sufficiently for long term change to be made.
Despite our second visit to “special measures” in a short space of time it appears that the divisive Executive Team remain in situ. Since the CQC visit, things have worsened dramatically – the imposition of impossible deadlines, no clear sense of direction of travel and veiled threats do nothing to enhance patient care, and produce a sense of cohesiveness and wellbeing for staff.”

When I read the response of the chair, Anne Shaw, I knew there was seemingly little hope of change for that anonymous senior manager. A humble, caring, compassionate leader would apologise to the manager who had felt so powerless and thank them for taking that step, that obviously cost them dear, especially when the CQC had mentioned their concerns about the culture too. 

However, her response underlined how dysfunctional the management team had become.  The Grimsby Telegraph reported ‘in response, Ms Shaw, hit back at the author
Ms Shaw, said: "We need people like that to think about what they are doing. My door is always open to talk to staff. I want people with concerns to come to me first.
"Headlines like this make people feel anxious and upset and don't tell the whole story. It bears no relation at all to us as an organisation.
"This person is part of the reason the trust is in special measures. This individual is disappointing and is clearly frustrated.
"Any staff member who doesn't feel valued has people who they can talk to."

Having made that attack on the anonymous author, the newspaper report went on to say -
Ms Shaw also apologised on behalf of the trust for its lack of efficiency, and blamed the CQC's findings on "complex and numerous issues", as well as the "sheer number of people" seeking care, who go to hospital with complex needs.’

Yes, the numbers of people seeking treatment have risen alarmingly and it is a huge problem for trusts but what was the management speak all about - these "complex and numerous issues”!

 There you have it, a trust in great difficulty and a management that is still allowed to function, even though the CQC officials said they remained concerned about the organisation's culture, adding:
"There was a sense of fear amongst some staff groups regarding repercussions of raising concerns and bullying and harassment".  – Care Quality Commission reported by ITV News.

For the sake of the anonymous whistleblower, I hope s/he hasn’t been identified and is able to leave before more damage is done to that person’s health and family life,  that the writer described.

What hope is there for those employees while the trust continues with those managers, and how many staff will give up before then and get out, whilst patients continue to suffer?

Yours despairingly

Tuesday, 30 May 2017

Action, not words, is needed but what?

Action, not words, is needed but what?

Recently I was able to attend the Turn up the Volume 2 conference in London, called and arranged by Steve Turner.  See for details of Steve’s career and extensive experience.  In particular, in 2014 he set up and continues to manage Care Right Now (CIC) a Social Enterprise Company delivering healthcare service development, based on education and learning.  And yes, he was a whistleblower with the usual destructive outcomes.  Grim but after recovery from the harm, Steve is very much back in action.  Inspirational.

Steve had lined up an eminent group of people to describe what they are doing to try and change the culture in the NHS so that it is safe for whistleblowers to speak.  Better still of course would be no further need for whistleblowing, with listening and responding trust boards, as some are now starting to do.  We can dream that one day it will be all trusts.  (See the website Care Right Now (CIC) for details of the speakers at Turn Up the Volume 2.

There were frequent opportunities for the audience to contribute their thoughts. Many of the audience were whistle blowers so well placed to speak.  

When the website was set up in June 2003 it attracted a small group of people who had fallen foul of their organisations, had experienced the horror of suspension, the worst thing that had ever happened to them, one of them concluded.  These people joined me in helping people in similar situations and we all began to campaign.  Some have continued but I stopped to care for my husband.  He was set free from Parkinson’s disease last year and I am free to return to the campaigning.  I am also in the process of updating the website.  

I went to the conference to get some ideas of what is happening nationally and what CAUSE (Campaign Against Unnecessary Suspensions and Exclusions UK) can do to try and stop the injustice and inhumanity of unfair suspensions and all it entails. 

En route I read the document published in 2014 by the whistleblowing helpline called ‘Raising concerns at work’. (See to read or download a copy.) The Secretary of State for Health, Jeremy Hunt, wrote in the Foreword,
‘Staff should be supported and protected when they raise concerns, as well as praised for their courage and thanked by management as a key part of the effort to build a safe, effective and compassionate culture that patients, service users, the public and the overwhelming majority of staff across health and social services expect.’

A loud amen to that but it is not happening everywhere and the usual horror story follows.  More action is desperately needed. Contact with your suggestions for what can be done please.  

Here is to justice and truth and patient focused honest care.

Tuesday, 12 January 2016

So what are whistleblowers up against?

Poetry makes the point

One of my great sadnesses is that staff in the NHS and elsewhere fail to understand the immense suffering caused by wrongful suspension, whether it be for a mistake, whistleblowing or false allegations from a jealous colleague. 

Becoming mentally ill is the norm, since people are unable to think clearly or sleep, and appetite disappears - all ingredients for physical and mental illness.  The body just can’t take the strain especially as the victim is usually a person of integrity with high personal standards and a great love for their job.

 I wrote an article for the Health Service Journal some years ago and the HSJ commissioned a cartoon.  The artist showed a huge liner leaving a distressed NHS employee stranded on a tiny island while it sailed into the sunset.  Brilliant.  It probably helped with my dismissal, a small but painful price to pay?

More recently, a sufferer of injustice has been putting pen to paper and conveying something of the powerlessness of the victim and the unaccountability of the well paid perpetrators.  Read on….

Whistle and they’ll come for you…

I’m the last of the radical nurses
I’ve got Bevan tattooed on my bum
and I believe that the sickest of patients
get the least care and that’s wrong.

I don’t like this tick-box culture
nor doing the care on the cheap
and I don’t think the family silver
should go to a great private heap

I think that the management tiers
pay themselves what I consider excess
as they preside over a system that’s failing
and ensure staff are blamed in the press.

I’ve watched all my NHS heroes
Graham Pink, David Drew….Rita Pal
speak out for what they believe in
to get thoroughly trounced
and I howl!

I’ve gone up the management ladder
to raise my concerns time by time…
So these poems are my very last option
to whistle blow here in bold rhyme.

Written warning
A word of wisdom in your ear…
‘You care too much!’ they said
Our job is ticking boxes
We are audit culture lead.

So take your fine ideas
You can protest in your head
Our job is ticking boxes
Initiative is dead.

Part of the union
When we asked for some support from the union,
we were bowled over when we were told
You must do as your managers tell you
And you’ll keep a job ‘til you’re old.

If they don’t want you to talk to the doctors
or log on their computers… OK.
It’s only about vulnerable patients
So not the management plan to this day.

and finally with thanks to the author who for obvious reasons has to remain anonymous….

Speaking up

If you are a doctor
they damn your career to hell.
And if you are a nurse
they discipline you if you tell.

But if you’re at the very bottom
the kicks and cuts are tough
from your erstwhile colleagues
when you are beaten up.

The suits who take the salaries
they really don’t want to know
as their next promotion
is where they are keen to go.

So don’t speak up for the patients
The vulnerable and the old
‘Cos when you work in healthcare
You should just do as you’re told.

Again my sincere thanks to the author of these verses.  They capture so much, so well.  I hope they get a wide readership.

And judging by the steady numbers of staff still contacting the team, nothing has changed.  Dire for us all, in every capacity.


Friday, 16 October 2015

Can people recover from suspension and other workplace bullying?

Is there any help anywhere?  Read on……

‘Tim Field, who died in 2006 aged 53 from cancer, was a world authority on bullying and psychiatric injury, and author of the best-selling Bully in Sight (1997). His vision was for a bully-free world, and he campaigned in schools, further and higher education, and the workplace to achieve this.

In 1994, after nearly 20 years working in computing, he had himself been a victim of workplace bullying and suffered a breakdown. After recovering, he became passionate about understanding and dealing with the problem.

He set up the UK National Workplace Bullying Advice Line in 1996, and then an information website, Success Unlimited (later Bully Online), which was widely used. He formed a publishing house from which he released Bully in Sight. One review said: "Thank you for writing Bully in Sight. It's like a torch in the darkness." Tens of thousands of copies were sold in 30 countries. In 1998 Field published David Kinchin's Post Traumatic Stress Disorder: the Invisible Injury. Then, in 2001 he co-authored and published (with Neil Marr), Bullycide: Death at Playtime, an exposé of child suicide caused by bullying.

He lectured all over the world. His clients included individuals as well as institutions such as the BBC, trade unions, police forces and local authorities. He worked personally on more than 5,000 bullying cases, highlighting the lack of understanding for victims. He revealed patterns showing how trade unions often failed to deal effectively with the problem among their members.

Field believed that bullying was the single most important social issue of today, and that its study provided an opportunity to understand the behaviours which underlie almost all conflict and violence. His work inspired and influenced international anti-bullying organisations, while his personal energy, commitment and knowledge restored sanity and saved lives.’  (Written by Will Messenger )

This year’s Memorial lecture is on Saturday, 7th November 2015 ‘Surviving Bullying at Work ‘
to be presented by Dr Keith Munday.  

It will draw on the findings of recently undertaken research which explores the experiences of those who have been bullied by their co-workers. Some of the factors which facilitate post-traumatic growth will also be considered.

Proceedings will start at 1.15pm, in the Sumpner Lecture Theatre, Floor 6, Main Building, Aston University, Birmingham, B4 7ET, UNITED KINGDOM

(15 minutes walk from New Street Station).



Hope you can make it.

With very best wishes for your own recovery journey