The Royal College of Obstetricians and Gynaecologists (RCOG) has undertaken the first investigation into incidents of bullying and undermining among obstetrics and gynaecology (O&G) consultants in the UK.
The study, published in BMJ Open, involved 664 consultants who took part in a survey in 2014. It showed that 44% (290) of those who responded had been persistently bullied or undermined. This represents 14% of the consultant workforce.
The types of behaviours most reported were persistent attempts to belittle and undermine an individual’s work; undermining an individual’s integrity; persistent and unjustified criticism and monitoring of work; freezing out, ignoring or excluding and continual undervaluing of an individual’s effort. Victims report that those senior or at least close in the hierarchy such as lead clinicians, medical directors and board level executives carry out most bullying and undermining.
Two thirds of consultants identifying themselves as victims of bullying and undermining suffer major or moderate effects, the survey also found. This could range from taking sick leave to moving position, depression and reduced confidence. When asked if the problem was being addressed, 73% of those who answered this question stated that it was not.
Study co-author, Dr Joanna Mountfield, consultant obstetrician and chair of RCOG’s Specialty Education Advisory Committee, said: “This is the first study looking at this issue at a senior level and it provides us with a more holistic view of the situation. We recognise that as the survey was self-selecting the sample may over represent the proportion of victims and those who have encountered bullying and undermining may have been more likely to take part. Despite this, the results still represent a significant segment of the RCOG membership who need more support and we should acknowledge and address the scale of the problem in all grades of staff.
“The RCOG has already undertaken much work to tackle this problem. Together with the Royal College of Midwives we have developed a bullying and undermining toolkit with practical advice and examples of the action doctors and midwives should take when they encounter unacceptable behaviour in the workplace. We have also developed an e-Learning resource to help health professionals from all backgrounds improve how they deal with colleagues, provide feedback, and respect cultural differences.
“Additionally, Workplace Behaviour Champions have been established in every Local Education and Training Board/Deanery to offer informal support to trainees if they run into problems and we are now considering extending this support to consultants and other career grade staff.
“We are encouraged to learn that when action has been taken to tackle undermining and bullying in units with supportive management, positive change has been achieved. However, the findings of this survey suggest much more needs to be done both locally and nationally including an overhaul of the current reporting and investigation processes within Trusts.
“This data is congruent with the reported rates of bullying and undermining in the NHS staff survey and suggests we are not the only specialty dealing with these issues. Lord Carter‘s recent report also recommended Trust chief executives lead work on reducing the incidence of this behaviour in their organisations.”
