good governance institute .appendix 2 page 43. 5 good governance institute executive summary

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GoodGovernanceInstitute

Worcestershire Acute Hospitals NHS Trust An independent investigation into how the Trust carries out reviews of allegations of bullying and harassment, under the Trusts Dignity at Work Policy

Final report

Good Governance Institute

www.good-governance.org.uk

July 2015

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Good Governance Institute

GoodGovernanceInstitute

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GoodGovernanceInstitute

GoodGovernanceInstitute

Worcestershire Acute Hospitals NHS Trust An independent investigation into how the trust carries out reviews of allegations of bullying and harassment, under the trusts Dignity at Work Policy

Client: NHS Trust Development Authority Project name: Worcestershire Acute Hospitals NHS Trust: An independent investigation into how the Trust carries out reviews of allegations of bullying and harassment, under the Trusts Dignity at Work PolicyDocument name: Worcestershire Acute Hospitals NHS Trust: An independent investigation into how the Trust carries out reviews of allegations of bullying and harassment, under the Trusts Dignity at work policyDate: July 2015Authors: Dr. Rekha Elaswarapu, Associate, Good Governance Institute; Ann Lloyd CBE, Senior Associate, Good Governance Institute; Candy Morris CBE, Senior Associate, Good Governance Institute; Jayne Brown OBE, Director, Good Governance Institute.Reviewed by: Andrew Corbett-Nolan, Chief Executive, Good Governance Institute.Researcher: TomMytton,SeniorResearchandDevelopmentOfficer,GoodGovernanceInstitute

This document has been prepared by GGI Limited. NHS Trust Development Authority commissioned this report.

The matters raised in this report are not limited to those that came to our attention during this assignment and

are not necessarily a comprehensive statement of all the opportunities or weaknesses that may exist, nor of all the

improvements that may be re-quired. GGI Limited has taken every care to ensure that the information provided in

this report is as accurate as possible, based on the information provided and documentation reviewed. However, no

complete guarantee or warranty can be given with regard to the advice and information contained herein. This work

does not provide absolute assurance that material errors, loss or fraud do not exist.

This report is prepared solely for the use by the NHS Trust Development Authority and Worcestershire Acute Hospitals

NHS Trust. Details may be made available to specified external agencies, including NHS England and external

auditors, but otherwise the report should not be quoted or referred to in whole or in part without prior consent. No

responsibility to any third party is accepted as the report has not been prepared and is not intended for any other

purpose.

Throughout this report we have included non-attributable quotes taken from some of the many people we spoke with,

as a means of helping to highlight elements of the report and our findings. These quotes are iden-tified in blue text.

2015 GGI Limited

GGI Limited, Old Horsmans, Sedlescombe, near Battle, East Sussex TN33 0RL is the trading entity of the Good Governance Institute

info@good-governance.org.uk

www.good-governance.org.uk

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Good Governance Institute

Contents

Executive Summary

1. Introduction page 7

2. Background page 7

3. Terms of Reference Page 9

4. Methodology for Review Page 10

5. Analysis of dignity at work policy and processes relating to raising concerns Page 12

6. Contributors to the evidence sessions Page 14

7. Stage One Analysis Page 17

8. Key findings derived from the analysis at Stage One Page 24

9. Benchmarking against similar Trusts Page 30

10. Analysis of findings at Stage Two Page 33

11. Conclusions from all of the evidence Page 36

12. Recommendations Page 37

Appendix 1 Page 38

Appendix 2 Page 43

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Executive Summary1 Introduction

The full report sets out the conclusions of a formal investigation into how Worcestershire Acute Hospitals NHS Trust (WAHT) carries out reviews of allegations of bullying and harassment, under the Trusts Dignity at Work policy.

Following allegations of bullying and harassment at WAHT, the Trust Board decided it required further assurance and it agreed with the NHS Trust Development Authority (TDA) that they would commission the Good Governance Institute (GGI) to carry out an independent investigation into how the Trust carries out reviews of allegations of bullying and harassment, under the Trusts Dignity at Work policy.

GGI was asked to consider and investigate the Trusts application of its Dignity at Work policy and management of formally lodged cases and in particular the following issues:

Whether the Trust has applied the Dignity at Work policy consistently Whether there is any evidence to show that the Trust has failed to take allegations of bullying and/ or harassment seriously Consider the reasonableness of the application of these policies, with reference to other comparable Trusts What recommendations, if any, could be made in respect of the future application of the Dignity at Work policy e.g.; Francis report and other sources of best practice What recommendations, if any, could be made about the content of the Dignity at Work policy

2 Methodology

A senior team conducted the investigation with extensive experience at board level within the public and private sectors. GGI used a clear methodology and explicit standards of evidence, designed to protect both the integrity and identity of those who had raised issues as well as those who would be involved in the investigation process.

Furthermore, GGI was required to undertake this investigation in accordance with the Trusts internal policies and with particular regard to the Trusts:

Dignity at Work Policy Grievance Policy Whistleblowing and Raising Concerns Policy

The investigation partly comprised of a desktop review of the application of the Dignity at Work policy and other documentation and supporting evidence. The investigation also heard from any witnesses, including staff, who felt they had genuine concerns that needed to be raised as part of this review. For the avoidance of doubt, the investigation was not intended to re-open any previous investigations under the policy, but to consider how the allegations that were reported to the Trust were dealt with, together with the Trusts overall approach in encouraging reporting of such issues. This included the Trusts staff engagement activities.

During the review process we identified that it was important that we interviewed as many staff as possible. The original timeframe of the review was extended to accommodate this.

Additionally, on the basis of our evidence gathered, we identified that the concerns around bullying and harassment were more deep-rooted than simple adherence to policy and practice. Hence it was important to understand the perceptions of the organisational culture so that the review could be set in context and a balanced outcome achieved.

We also noted that a number of staff were worried about the confidentiality issues and in response to this we undertook a confidential and independent survey of staff working at the Trust.

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This led us to conclude that the scope of the review as well as timeframe required broadening. Following approval from the TDA, we extended the review timeframe and increased the number of interviews and staff surgeries.

Over 100 people were interviewed, at different levels, from all three sites of the Trust. Survey responses were received from 721 staff and 24 people responded to our confidential email address.

This additional testimony gathered from internal and external stakeholders, together with the survey, provided a more robust evidence base, and allowed us to respond to the questions in the terms of reference in a more comprehensive way.

3 Overarching Conclusions

There is insufficient evidence to conclude that bullying and harassment is endemic at the Trust but the review revealed some specific issues which require immediate action The Dignity at work Policy is not fit for purpose either as a document or in the way it is administered There are inconsistent and confusing approaches within the Trust in regard to the management of concerns raised by staff. Processes lack transparency and there is no single operating model across teams or Directorates The Trust has divergent views among different teams as to what constitutes bullying and harassment which exacerbates inconsistent approaches to policy and to investigations The Trust needs to take stock of its leadership and management culture in the context of an organisational development plan

4 Recommendations

The following recommendations are proposed from this investigation and are grouped into three areas of Policy, Practice and Training. The Trust should:

Policy

1. Immediately make an explicit statement in relation to zero tolerance of bullying and harassment and make clear to staff how they can raise concerns within the organisation. 2. Immediately Identify a board champion for Dignity at Work, and appoint an independent expert to whom staff can refer their concerns. 3. Within 6 months complete a full review of recruitment and retention policies to assure the board that these are transparent and fair. 4. Immediately review the Dignity at Work Policy with specif

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