The leadership of a prominent cancer trust acted in a ‘defensive and dismissive’ manner when serious concerns were raised about bullying behaviours and multiple failings in the handling of a major research contract, an external review has found.
As previously revealed by HSJ, NHS England commissioned the review into events at The Christie Foundation Trust after whistleblowers raised numerous concerns over a research project with pharmaceutical giant Roche, and about the way they were treated as a result of speaking out.
The NHSE review, which was led by Angela Schofield, chair of Harrogate and District FT, was published earlier today within trust board papers. It described the trust’s research division as “ineffective” and said it had “allowed inappropriate behaviours to continue without challenge”.
The 18 page review added: “It may… be thought to be surprising that NHSE/I found it necessary to commission an external rapid review to look into concerns which had been raised by colleagues within the research and innovation division.
“The root cause of this seems to be an apparent failure by those people in leadership positions who were aware of the concerns that had been raised, in the circumstances covered by the review, to listen to and take notice of a number of people who have some serious issues about the way they are treated and wish to contribute to an improvement in the culture.
“The leadership of The Christie had a number of opportunities to avert this rapid review as colleagues in the R&I division began to speak up about their concerns. Not only did they not seem to recognise this but there were occasions when they appeared to be defensive and dismissive.”
However, the board papers also include a bullish 14-page response from the outstanding-rated trust.
It states: “Regretfully, there are a small number of [trust] staff who are dissatisfied or aggrieved and whose concerns we consider carefully. However, the clear conclusions of the [NHSE] regional office and the objective data based on surveys of 1,500 staff in our organisation and 175 staff in our R&I division suggest that, whilst improvements can be made, we do not have systematic problems with discrimination, bullying or responding to concerns.
“The board of directors has agreed to support the report’s recommendations whilst noting the majority were already encompassed by the trust’s existing action plan at the time of the review….
“There are a number of comments in the report which the board of directors believes are not accurate and for which the evidence base has not been provided. It would have been of great help to the board of directors for there to have been an opportunity to discuss these and other details in the report with the review team.”
The NHSE team highlighted multiple shortcomings in how the research project was handled by the Manchester trust - echoing the findings of a previous review commissioned by The Christie - as well as criticising how internal concerns around the project were handled, saying a freedom to speak up investigation process lacked support and was “mismanaged”.
It also summarised the experiences of 20 current and former staff members who said they suffered “detriment as a result of raising concerns”, although it did not make a clear judgement on whether their claims were justified.
They said: “An experience of bullying, harassment and racial prejudice was described along with lack of respect at work… Patronising behaviour, humiliation and verbal aggression by managers and clinicians in public and private spaces contributed to the perception that working environments were emotionally unsafe.”
There “appears to have been a view [from the trust] that negative comments are limited to a small number of colleagues”, the reviewers said. But they stressed some of the people who came forward are “long-standing, loyal, senior staff on whom The Christie relies for effective management day to day”.
They also criticised a possible “over-reliance on staff survey results” and said this should be complemented with “structured listening”.
The review said the “long working relationships” of those in senior positions have created a notion of the “old guard”, and that executives are located in an “ivory tower” although it said this was a common perception across many organisations.
Some of the individuals who made bullying allegations were described as bullies by others, the review added. It also found no evidence of bribery and embezzlement by employees of the Christie, which had been among the allegations made.
On alleged racism, the reviewers found no evidence of a “systemic or widespread racism problem”, but said there are “individuals or isolated pockets within the workplace where some staff perceive that they have been treated differently because of their race/ethnic background”.
They said the trust should seek feedback from minority ethnic staff around its recruitment, promotion and disciplinary processes.
Like many specialist trusts, The Christie is rated “outstanding” by the Care Quality Commission.
A spokesman said in a statement: “It is important to note that at no stage were any concerns raised about patient care. The review concludes there is no evidence of any wrongdoing by staff or board members in relation to allegations of bribery and embezzlement, and no regulatory intervention or action is required.
“As with all organisations, there are always things that can be developed and enhanced, and we are constantly seeking to learn so that improvements can be made for the benefit of both staff and patients.”
In a letter presenting the report, NHSE said there had been leadership changes within the R&I division.