NHS Blood and Transplant (NHSBT) has been told to improve its workplace culture and approach to equality, diversity and inclusion (EDI) after the care watchdog found evidence of bullying, harassment and discrimination, particularly against ethnic minority employees.
The Care Quality Commission’s inspection was triggered after it received whistleblowing reports from current and former staff that raised concerns with the quality and safety of some services, and a a “toxic and unhealthy” culture.
Workers highlighted examples where they had been disrespected and discriminated against and situations where their views had been disregarded. Many of these complaints related to recruitment, development and fair treatment.
There was also evidence that staff from ethnic minority backgrounds and those with other protected characteristics had suffered detriment, the CQC’s inspection report said.
A May 2022 survey found that in the previous 12 months, 15% of staff from a black, Asian or minority ethnic background had experienced discrimination from their line manager, team leader or other colleague, in comparison with 7% for those from a white British background.
Fifteen per cent of ethnic minority staff said they had faced harassment, bullying or abuse from managers or colleagues, versus 12% of white British employees.
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Staff told CQC inspectors that NHSBT’s work around diversity and inclusion felt “tokenistic” and did not lead to sustained improvements. Some felt inequality had been a long-standing problem.
There was no overarching EDI strategy in place, but there were several separate directorate strategies. The report notes that a new lead for equality, diversity and inclusion joined the organisation shortly before the inspection took place.
Although there were mechanisms for employees to raise concerns, including through the NHS’s Freedom to Speak Up Guardians programme, there were not enough “champions” to support staff across the service’s 41 sites.
The inspectors found that the organisation lacked a culture of collective responsibility. Although there were positive relationships between colleagues and teams, conflicts were not always resolved quickly and constructively.
Some staff said they were reluctant to bring issues to the board because of the “unprofessional conduct of others” which had affected relationships and how teams had functioned.
Deanna Westwood, CQC’s director of operations, south network, said the body has made it clear to NHSBT that these issues must be addressed.
“We shared our immediate feedback from the inspection with senior leaders and they are clear on the areas of concern and governance issues that need to be addressed. Board members recognise and accept they have work to do to improve diversity and equality across the organisation, and we will continue our regular contact with NHS Blood and Transplant to monitor the quality and safety of services as they progress their improvement plans,” she said.
An NHSBT spokesperson said: “The CQC has confirmed it found our services to be safe for donors and patients. They found people at NHSBT to be positive and proud to work here with a clear commitment to provide high-quality services.
“We have already begun to address the issues identified in the report and are an improved organisation from the one the CQC inspected this summer. We fully accept the findings and recommendations and are putting in place a comprehensive action plan.”
Commenting on the case, Anthony Sakrouge, a partner and head of the employment team at law firm Russell-Cooke, said that, where a toxic working culture has developed, organisations should recognise the problem and ensure managers receive training on good leadership that covers diversity and inclusion.
“Feedback on the working culture within an organisation is rarely entirely positive, especially when given anonymously, as the pressure on management to achieve results can lead to employees feeling undervalued, harassed, or even bullied,” he said.
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“However, if the organisation is being run well, feedback should be mainly positive, as any inappropriate conduct should be checked at an early stage. A failure to recognise this at a very senior level tends to lead both to high turnover of staff and reputational damage.”
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