Toxic Workplace Culture: The Hidden Epidemic within the NHS

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Scroll through social media or any popular news site and there’s article after article detailing toxic behaviour and a ‘culture of bullying’ amongst NHS trusts throughout the UK.


But the presence of toxic workplaces in the NHS isn’t new and shouldn’t really be a shocking discovery. There have been many articles published over the years uncovering this same problem, including this one by The Independent in 2018 detailing how NHS bullying isn’t just toxic for staff, it’s costing billions. Even NHS Employers published an infographic in 2020, that provided a range of key statistics about the impact of bullying on NHS employee wellbeing.

But the problem isn’t necessarily identifying the issue, it’s acting on it. You don’t need to spend your time finding additional proof that there is a culture of bullying and harassment in all workplaces, including the NHS.. Just Google ‘NHS toxic culture’ and you’ll discover an overwhelming set of evidence. There are thousands of employers who take this first step to identify issues, conduct office polls, create reports and hold focus groups; but does anything actually come of it? The answer is often no, and this seems to be no different within the public sector in the UK, including our treasured NHS.

In this article, we take a deeper dive into Culture Shift’s latest report which looks at how problematic behaviour is impacting the NHS and what happens if workplace culture is left uncared for, plus gives some helpful tips on what you can do to protect healthcare workers from poor behaviour, and improve your overall culture.
No doubt the bullying and harassment epidemic has been overshadowed by the pressure of COVID-19 and that has meant issues have been easily swept under the rug. But, we see on the news repeatedly that staffing is the number one threat facing the NHS today and it’s clear that the culture amongst the workforce is a huge contributing factor to that. The pressure because of the pandemic has meant problematic behaviour has gotten worse over the last 18 months, so it’s not a problem that’s going to go away simply by being ignored.

The COVID-19 pandemic has also left more people prioritising and choosing their well-being and work-life balance like never before. Culture Shift’s CEO, Gemma McCall, commented in our latest report: “The pandemic has left employees more aware of what is truly important to them; whether that’s a good work life balance or a workplace with a strong culture of trust and respect, and they’re voting with their feet.”

It’s in all employers best interests to find actionable, effective solutions to this growing problem, and to recognise that prioritising their staff’s well-being is the number one way to retain staff and in regards to healthcare, it’s vital NHS, it isn’t sustainable with how it is presently.

In our ‘Paying the price’ report we found that 52% of Healthcare employees had experienced problematic behaviour, with 49% looking to leave as soon as they can find a new job. It’s no secret that the NHS is understaffed and underfunded. But with over half of their employees experiencing problematic behaviour and more media coverage about it all the time, this is a problem that’s only going to get worse if we don’t adopt radical change now. Having a culture where bullying and harassment goes unchecked is costing the NHS its reputation as an employer just as much as it’s costing them billions financially. Which begs the question: how many more people will start a career in the NHS when it’s common knowledge that the culture is bad?

As shown, as of 2020, if every staff member that has been bullied left the NHS it would mean a loss of 42,681 members of staff and the cost of replacing those people would be £231.9m (it costs on average £30,000 to replace a lost employee). This is staggering, and not a theoretical problem with 49% of Healthcare employees that have experienced bullying, harassment, discrimination or sexual misconduct looking to leave their jobs as soon as they can find something better.

The value that kind of money would have elsewhere, is really why it’s in all NHS Trust’s best interest to do something about this growing problem. Not only because it’s the right thing to do for staff well-being but also for the financial future of the NHS.

The NHS state that their Freedom to Speak Up Guardians are the solution. But allegations coming out from staff on the ground say that the guardians are “nothing but a box ticking exercise” which at the very least proves they are not enough to shift the perception that bullying and harassment isn’t taken seriously in the NHS. That’s not to say that the NHS is worse than other employers. Anywhere there are people, there are problems, and for the biggest employer in Europe it’s a given that this is happening on a fairly large scale. But with the strain on recruiting, training and retaining staff being a dominant issue for the NHS today, bullying and harassment is a contributing factor that they can’t ignore.

Time and time again, nurses and other healthcare staff have bravely come forward stating they’re too afraid to speak up in their workplace.

With nearly one in three healthcare workers afraid to report their boss for bullying due to fear of repercussions, the case for anonymous reporting is clear.

This isn’t to say that Freedom to Speak Up Guardians aren’t an effective solution but as it stands, they can’t be the only solution available. When it comes to bullying and harassment you need to give employees multiple ways to disclose so they can choose a solution that feels most safe and comfortable to them. That’s why at Culture Shift we truly believe in the power and importance of anonymous reporting as a vital first step for many victims who will never find the courage to let you know what has happened any other way.

It’s time to recognise the difference between ‘ticking a box’, and doing something that actually makes a difference and makes the NHS a better place to work for all of its people. Anonymous reporting offers a tool to support and assist Freedom to Speak Up Guardians in the work they’re already doing.

With nearly one in three healthcare workers afraid to report their boss for bullying due to fear of repercussions, it’s clear that trust is a huge issue for NHS staff right now. But by implementing better reporting solutions and making changes on the back of disclosures you receive, even anonymous ones, you will start to build trust and help more people come forward

Anonymous reporting provided by an external source is the first stepping stone in identifying the real issues going on from within. From our experience it’s also going to be crucial in how the NHS can tackle the problematic behaviour crisis. You don’t know what you don’t know, so giving people a way to feel more comfortable about disclosing their experiences is vital.

Culture Shift can help with all of the above with our Report + Support™ system. When employees are given the opportunity to report unacceptable behaviour – anonymously if they wish – and receive support to put a stop to it and resolve issues, organisations working culture can be improved. Employees will feel more confident in their employers’ awareness and actions in regards to issues and problems in their work environment.

How can we help you?

Reach out to our dedicated team who will be happy to answer any questions you may have.

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