‘Corrosive’ NHS trust is reluctant to accept criticism, watchdog says

• The father of a doctor who took her own life after experiencing bullying at the University Hospitals Birmingham NHS Foundation Trust wants lessons to be learnt after the review was published on Tuesday.

A review describing a toxic culture of bullying at one of the country’s largest NHS trusts shows its “reluctance to accept criticism”, a health watchdog has said.

Rob Behrens, the Parliamentary and Health Service Ombudsman (PHSO), said University Hospitals Birmingham NHS Foundation Trust (UHB) is still dealing with a “legacy of defensiveness” as a new report laid bare the extent of an “entrenched” and “corrosive” staff culture which could pose a risk to patient safety.

The Ombudsman said earlier in March that 501 complaints had been received about the trust since January 2021, as well as multiple instances of avoidable patient death, but the trust had demonstrated a “failure to fully accept or acknowledge” the findings.

The report released on Tuesday, led by Professor Mike Bewick, a former NHS England deputy medical director, and commissioned by NHS Birmingham and Solihull Integrated Care Board, echoed these concerns, saying the trust was “culturally very reluctant to accept criticism”.

Mr Behrens said: “This report will make for hard reading for the new leadership and sets the scale of the challenge they face. It backs up our concerns about University Hospitals Birmingham in terms of culture and patient and staff welfare.

“While we have seen some improvements when working with the trust, as the report makes clear we are still dealing with a legacy of defensiveness and reluctance to accept criticism that needs to be addressed.

“We have a shared aim of ensuring that patient safety incidents are not repeated, but for that to happen the trust must start to accept accountability and learn from its mistakes, instead of shying away from criticism.

“The trust must start to implement these recommendations and make significant improvements in its culture and leadership so that people living in the West Midlands can access the best possible care with confidence.”

The review said the trust’s patients were safe overall, but it made 17 recommendations for further action to address clinical care and culture issues.

The second and third reviews, which will focus on governance and culture, will be released in the summer.

Prof Bewick said in his findings that “there is much more work to be done” after staff reported concerns over bullying and fear of retribution, but added that goodwill from the trust had “dissipated” as the review went on.

He added: “During our short review, we have received significant co-operation from the trust in terms of access to individuals and documentation.

“However, as our work has progressed, we have found that this goodwill has dissipated, and have seen an organisation that is culturally very reluctant to accept criticism or to acknowledge the adverse views expressed by us and other significant external bodies.

“We do not direct this at the trust’s interim leadership team, but others seem to be, or have been, far less open to any suggestion that there are problems at UHB.”

Concerns over patient care at the trust forced the PHSO to enact its emerging concerns protocol for the first time in August, allowing it to share information about a hospital that may indicate risks to patients, their families and carers, and staff.

However, Mr Behrens has previously criticised the reviews as lacking “completeness and transparency” after he claimed the PHSO was not invited to contribute to the first review, despite the findings of its own investigation into UHB uncovering “real concerns”.

It has since received assurances that it will be able to write a letter sharing its concerns for the second review, and will be able to contribute fully to the report on culture.

After the first review, chief executive Jonathan Brotherton said the trust fully accepted the findings and that it had started to address the “number of significant concerns” raised.

“While we will not be able to fix things as quickly as I would like, we do need to do it as quickly as possible, for the benefit of patients and staff. I am committed to ensuring this happens,” he said.