Report from anonymous physician ‘damning’ to NHS

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An anonymised “personal view” by a former NHS consultant OH physician has painted a damning picture of attitudes to OH and workplace health and wellbeing within the NHS.

The article, published in the BMJ in March, has made a clear link between the scandals that hit the Mid Staffordshire NHS Trust several years ago and the potential for workplace pressure and poor management to “brutalise” staff.

In the article, the consultant highlights an environment where even the creation of anonymised statistics on work-related ill health was something seen by managers as “likely to cause them trouble and to provide ammunition for staff who were thinking of making compensation claims”.

The author added: “I was told that no other NHS OH department produced such reports, and they were ‘filed’ in the bin.

“NHS management seemed not to understand that it had a duty to protect its staff from the pressures under which they were working. This was a callous disregard for the overall wellbeing of staff.”

A subsequent analysis by the author concluded that healthcare workers were “some 70% more likely to have developed work-related stress, depression, or anxiety than the general workforce at that time”.

The author added: “The 2012 prevalence of work-related mental health problems in health professionals was 110% higher than in the general workforce, as shown in recent government statistics”.

There were six key reasons as to why this might be happening, the author contended:

  • First, the NHS was a labour-intensive, cramped, pressured, highly emotive industry.
  • Second, there was not enough resource devoted to OH, despite the high requirements for interventions such as immunisations or dealing with exposure to body fluids.
  • Third, “in most organisations, occupational physicians can appeal to senior management’s altruism to try to obtain resources to promote employee health and welfare. This does not work when you are directly competing with the urgent needs of ill patients and with on-going government initiatives to reduce waiting lists”.
  • Fourth, responsibilities for overseeing safe working practices were often not delegated, and no director was held responsible.
  • Fifth, there was high turnover of senior managers.
  • And finally, “when provided with evidence that there were escalating cases of work-related ill health, senior NHS managers usually put the increase down to greater awareness of cases. No action was taken to prevent recurrence. Eventually, the bearer of bad news was shot.”

All these factors, the author argued, “have led to the brutalisation of some NHS staff so that they no longer respond appropriately to distress in their patients, as recorded in the inquiry into what happened at Mid Staffs”.

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