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Bullying, Harassment & Undermining

Bullying, harassment, and undermining behaviour (BHU) has been reported in healthcare for many years and remains a concerning issue for staff wellbeing. The 2021 NHS Staff Survey found that almost 19% of NHS staff in England and Wales had experienced BHU in the previous twelve months.  Inquiries into failings in healthcare have identified team breakdown because of bullying and undermining contributing directly to poor care and high mortality rates. High rates of bullying are linked directly to high attrition rates, increased levels of depression and suicide, and a reduction in clinical competence. It is essential to detect these behaviours to target interventions and support staff, thereby optimising patient care.

Cardiothoracic surgery is a high-stakes specialty with acute pressures in the operating room at risk of outbursts of behaviour, which, if not managed appropriately, might lead to a breakdown of teamwork. Suggested barriers to reporting bullying include a failure to recognise BHU as abnormal, a lack of confidence in an adequate response, and a fear of a detrimental impact on career progression; this latter factor may explain why oppressive behaviours appear more common in smaller specialties.

The SCTS regards BHU as a serious issue and has launched a supportive network of mentors and established Sarah Murray, Lay Chair of the Professional Standards Committee, as the BHU Guardian for its campaign of zero tolerance. This has been disseminated to all cardiothoracic units in the country and sets a professional standard for working and investigating BHU.

We understand BHU is a complex and challenging issue. Reporting can be complicated when the perpetrators of BHU are immediate supervisors or those in a more senior position. There are several routes to report and raise this unacceptable behaviour taking this into consideration and aiming to protect all those involved.

Resources for self-reflection and support for SCTS members are sign-posted below.

Bullying, Harassment and Undermining behaviour

What is it?

Bullying Behaviour that hurts or frightens someone who is less powerful, often forcing them to do something they do not want to do. 

Harassment Unwanted conduct related to a protected characteristic which has the purpose or effect of violating an individual’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that individual. 

Undermining behaviour Behaviour that subverts, weakens, or wears away confidence. 

How common is it?

BHU is a societal problem, it can be embedded in culture and requires a commitment from everybody to ensure that it isn’t accepted and called out if it happens.

BHU not only affects the individuals involved but puts patients and staff at risk.