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NHSScotlandLatest NewsWorkplace culture

NHS Lothian review finds ‘toxic’ work environment

by Jo Faragher 2 May 2025
by Jo Faragher 2 May 2025 The review found that staff were 'close to burnout', leading to stress and higher absence levels
chrisdorney / Shutterstock.com
The review found that staff were 'close to burnout', leading to stress and higher absence levels
chrisdorney / Shutterstock.com

NHS Lothian has apologised to staff in its maternity care unit after an investigation uncovered a toxic workplace culture.

The health board commissioned an independent review after whistleblowers raised concerns about staff shortages and workplace relationships affecting patient safety.

One of its conclusions was that “concerns about bullying and a toxic work environment are prevalent”.

Additionally, it found that many staff felt “close to burnout” because of high workloads and inadequate staffing.

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In December 2024, an investigation upheld or partially upheld 17 concerns about safety, and NHS Lothian said it would put an improvement plan in place.

The death of a mother on the unit in September 2024 prompted further investigation, but staff continued to raise concerns about the workplace culture.

The workplace review found that there was distrust between managers and staff in maternity care, and just over a third of frontline workers said they felt unable to report unethical behaviour.

It found major challenges with the working environment, including staff shortages that had led to delays in women accessing treatment.

Relationships with leaders were found to be strained, which in turn caused problems with staff wellbeing, stress, and bullying. Some employees expressed experiences of unfair treatment and frustration.

Around half of the 1,195 staff in women’s services at NHS Lothian responded to the survey. Although half said their managers dealt fairly with everyone, 36% felt unable to report unethical behaviour without fear of reprisals.

In a statement, Tom Power, director of people and culture at NHS Lothian, said:

“We commissioned this independent research because we wanted to leave no stone unturned in our efforts to get a truly comprehensive picture of the experience of our teams in women’s services.

“I apologise to those who have been let down at work and reassure them that we are determined to support them better to do the job they love.

“I would like to reassure women and their families that they and their babies will receive high-quality care from our committed and professional staff.”

The health board continues to roll out a programme of improvements, including a plan to recruit almost 30 new midwives and other maternity staff.

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Jo Faragher

Jo Faragher has been an employment and business journalist for 20 years. She regularly contributes to Personnel Today and writes features for a number of national business and membership magazines. Jo is also the author of 'Good Work, Great Technology', published in 2022 by Clink Street Publishing, charting the relationship between effective workplace technology and productive and happy employees. She won the Willis Towers Watson HR journalist of the year award in 2015 and has been highly commended twice.

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