Workplace bullying in the UK NHS: a questionnaire and interview study on prevalence, impact and barriers to reporting

Abstract

ObjectivesTo examine the prevalence and impact of bullying behaviours between staff in the National Health Service (NHS) workplace, and to explore the barriers to reporting bullying.DesignCross-sectional questionnaire and semi-structured interview.Setting7 NHS trusts in the North East of England.Participants2950 NHS staff, of whom 43 took part in a telephone interview.Main outcome measuresPrevalence of bullying was measured by the revised Negative Acts Questionnaire (NAQ-R) and the impact of bullying was measured using indicators of psychological distress (General Health Questionnaire, GHQ-12), intentions to leave work, job satisfaction and self-reported sickness absence. Barriers to reporting bullying and sources of bullying were also examined.ResultsOverall, 20% of staff reported having been bullied by other staff to some degree and 43% reported having witnessed bullying in the last 6 months. Male staff and staff with disabilities reported higher levels of bullying. There were no overall differences due to ethnicity, but some differences were detected on several negative behaviours. Bullying and witnessing bullying were associated with lower levels of psychological health and job satisfaction, and higher levels of intention to leave work. Managers were the most common source of bullying. Main barriers to reporting bullying were the perception that nothing would change, not wanting to be seen as a trouble-maker, the seniority of the bully and uncertainty over how policies would be implemented and bullying cases managed. Data from qualitative interviews supported these findings and identified workload pressures and organisational culture as factors contributing to workplace bullying.ConclusionsBullying is a persistent problem in healthcare organisations which has significant negative outcomes for individuals and organisations.

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“…This rate is far higher than rates of bullying which have been estimated as only affecting 1-3% of doctors on a daily or weekly basis. 1 The data suggests that RDA communication encompasses a wide spectrum of behaviours, for which bullying is a subset of the wider problem.…”

“…Destructive or negative workplace communication is recognised to be a problem both in the NHS and other organisations [1][2][3][4] and has attracted concern following recent care scandals such as Mid Staffordshire and Morecombe Bay. 5,6 Negative workplace behaviours encompass a broad spectrum and most of the research on negative communication between doctors has analysed bullying or undermining as a discrete subset.…”

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“…exacerbate their psychological distress 49,50 . 60,74,75 , and/or pre-existing mental health conditions 60,75 .…”

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“…NHS (Carter et al, 2013) performed a workplace bullying survey in the UK NHS research and discovered that an overall 20 % of staff reported having been bullied by other staff to some degree and 43 % reported having witnessed bullying in the last 6 months. In addition, male staff and staff with disabilities reported higher levels of bullying.…”