‘Clique’ ambulance staff criticised in new report
Officials raised concerns about the culture in ambulance trusts.
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Your support makes all the difference.“Clique” ambulance staff have been criticised in a new report which suggests that target-driven cultures could be having a negative impact on ambulance trusts “just as it did at Mid Staffs”.
A national guardian has warned of negative cultures in trusts preventing workers from raising concerns as she called for a “cultural review” of ambulance organisations.
Mid Staffordshire NHS Foundation Trust was lambasted in national reports with a focus on how target-driven culture led to poor care which could have contributed to the deaths of hundreds of patients.
The National Guardian for the NHS, Dr Jayne Chidgey-Clark, has now said that pressures on ambulance trusts in England are leading to a “considerable focus” on targets – such as call answering, handover delays and ambulance response times.
Workers spoke about cliques between directors, managers and workers which was stopping people from raising issues because they feared the consequences
“A focus solely on targets can – especially under pressure – make us blind to how those measures are achieved and at what cost,” she said in a new report.
“I fear that a focus on targets may inadvertently be having a negative effect on the culture of ambulance trusts – just as it did at Mid Staffs.”
One senior ambulance leader told the review team: “When I first started, everyone I spoke to said we have a culture problem. Sexism, racism, homophobic, cliquey. We are going to fix it but not yet. We need to sort out other things like wait times.”
Dr Chidgey-Clark also raised concerns about staff not feeling they could speak up about concerns and described a “culture of silence” where “workers could often not speak up, and concerns were often unheard”.
Some people who had raised concerns “suffered detriment” as a result, she added.
“We heard about experiences of bullying, harassment and discrimination, she wrote.
“Workers spoke about cliques between directors, managers and workers which was stopping people from raising issues because they feared the consequences.”
The report called for an “independent cultural review” of ambulance trusts to help transform poor culture in the trusts.
The National Guardian’s Office and the role of the Freedom to Speak Up Guardian were created in response to recommendations made by Sir Robert Francis QC – who examined the failings into Mid Staffs – to help encourage NHS staff to speak openly when they had concerns.
Some of the findings in the latest report include:
– The culture in ambulance trusts was having a “negative impact” on workers’ ability to speak up.
– Some ambulance staff described bullying, harassment and discrimination.
– Workers spoke about “cliques” between directors, managers and workers which was stopping people feel able to speak up.
– Some staff felt raising concerns would not accomplish anything.
The report adds: “Broader cultural issues such as favouritism and cliques, ‘command-and-control’ decision making, and bullying and harassment were affecting workers’ ability to speak up and the confidence they would be listened to.”
Not supporting workers to speak up is having an impact on staff wellbeing and “ultimately patient safety”, the National Guardian’s Office said.
As well as calling for a cultural review into trusts, the report also recommends that trusts adopt speaking up as a “business as usual”.
It also called for better regulation of trusts to ensure staff could speak up when they felt they wanted to.
Dr Chidgey-Clark said: “Leadership throughout healthcare – including ambulance trust leaders and regulators – must do their part by listening to workers and treating their voices with the same respect as patients’.”
Daren Mochrie, chairman of the Association of Ambulance Chief Executives (AACE), said: “The Association of Ambulance Chief Executives welcomes this review, the greater insights it provides into the current workings of the Freedom to Speak Up culture, including the role of the guardians within NHS ambulance services, and the further opportunity it presents for comprehensive and consolidated improvement in this area for the benefit of staff and patients alike.
“Alongside and on behalf of our members, AACE will support and work with the National Guardian’s Office, NHS England and the Department of Health and Social Care to implement the recommendations and ensure that they have a meaningful and sustainable impact within the ambulance sector.”