GHP September 2015

ghp September 2015 | 41 health and social care Anti-bullying Policy at Worcestershire Acute Hospitals NHS Trust Recent press articles have highlighted how a report by the Good Governance Institute into the anti-bullying policies at the Worcestershire Acute Hospitals NHS Trust, particularly their ‘Dignity at Work’ policy, is ‘not fit for purpose’. The report elaborated by saying that the approach taken at the Trust was ‘inconsistent and confusing’ and failed to take staff concerns seriously. Another issue raised by the report was that there was confusion about what bullying actually is. Bullying Bullying can manifest itself in many forms, but the outcome is always that the bullied person feels under threat. A threat at work is invariably to do with losing something of importance. David Rock’s SCARF model (Rock, 2008) is a useful framework to use to cate- gorise the different types of bullying behaviour in the workplace. The framework gives an overview of what people at work most fear losing: • Status: Bullying can mean belittling a person, causing public professional humiliation, or making accusations of lack of effort. • Certainty: Bullying can mean preventing access to opportunities, or withholding information. • Autonomy: Bullying can mean failing to give credit where it is due, giving out meaningless tasks, removing responsibility, or shifting goal posts. • Relatedness: Bullying can mean calling people names or insults, teasing, or isolating them. • Fairness: Bullying can mean making unjustified accusations, showing lack of respect, or increas- ing the workload substantially. As well as these relatively subtle practices, bullying can also take more overt forms, like aggression, vio- lence, punishment and generally vindictive behaviour. The brain and bullying When under threat, the brain’s response is to focus on ensuring survival. Keeping on the alert for dangerous bullies all the time generates fear and anxiety, which leads to high levels of stress and all the subsequent health and emotional problems that this entails. Bullies at work are dangerous, and can damage co-workers health as well as destroy a team’s perfor- mance. If staff do not feel safe, or do not believe that they are valued or respected by their own manage- ment, they will find it difficult to deal effectively and compassionately with patients and with each other every day. This is why it is critically important to confront and deal with bullies promptly and effectively in the workplace. Although the Good Governance Institute investiga- tion found no evidence of ‘endemic’ bullying at the Worcestershire Trust, a large number of the more than 700 staff interviewed said they were concerned about ‘speaking out’ and that morale was generally very low. One of the key characteristics of an organization full of fear is that staff do not feel able to ‘speak out’. This fear culture was confirmed by one of the medics interviewed who was quoted as saying “The culture at Worcester is very pressured, the culture in Redditch is one of palpable fear…it is paranoid.” Bullying flourishes in organizational cultures suffused with fear. Research suggests that bullies behave in this way because they enjoy the feeling that power over others brings, or they may feel envious or threat- ened by their victims. Sometimes, the bullying behav- iour stems from physically or psychologically abusive events in the person’s family or personal background. By Dr. Sue Paterson and Joan Kingsley