An independent review has uncovered serious concerns about workplace culture at Forth Valley Royal Hospital.

Staff felt it was futile to report concerns about patient care at the emergency department because of a "perceived lack of action… [and] fear of retribution”, according to the report.

One staff member quoted by the review said speaking up any about any issues would be “held against you”.

NHS Forth Valley Chief Executive Cathie Cowan, who commissioned the investigation in December 2020, said the report was “very distressing” and was already being acted on by the health board.

The assessment looked into concerns that management had ignored inappropriate behaviour in the emergency department ‘over a prolonged period of time’.

It was completed in June and published ahead of a special board meeting last week.

Concerns raised by UNISON and the Royal College of Nursing also related to staff resignations and ‘professional concerns about safe staffing and patient care’.

Staff from the emergency department reported being ‘traumatised’ by experiences over a number of years, the report said, with some describing how colleagues were ‘brought to tears’

Half of the staff responding to the review team said they were not supported to report errors, with claims that a focus on meeting waiting time targets was often “at the expense of safety”.

It was suggested that reporting of concerns about staffing or overcrowding in the emergency department were “actively discouraged”.

The review team also issued a warning over the reporting of the most serious failings in patient care, escalating their concerns to the board medical and nursing directors early in the process.

A recent analysis by healthandcare.scot suggested NHS Forth Valley has one of the lowest rates of reported Significant Adverse Event Reviews (SAERs) in the country. The board has said “all incidents are fully investigated and reported in line with national guidance.”

NHS Forth Valley last week agreed an improvement plan to address the wide-ranging recommendations set out in the review.

This includes the recruitment of additional staff, protected learning time for emergency department nurses and a review of staffing levels.

NHS Forth Valley CEO Cathie Cowan said: “Over the last few weeks, I, along with our Chair, met with Emergency Department staff to discuss the review and any other changes or improvements staff would like to see. Our improvement plan therefore goes further than the review recommendations to incorporate many of the ideas, suggestions and solutions put forward by local ED staff.”

She added: “A number of the issues staff highlighted in relation to staffing, training and support can be addressed quite quickly. Others such as rebuilding trust, building relationships and improving teamwork will take longer, however, I am committed to ensuring that all of the issues raised are addressed.

“I want to again thank staff for taking part in the review and for showing great professionalism, courage and commitment throughout the review process. I look forward to continuing to work with local staff, managers, clinical leads and staff-side representatives to create a strong, positive working environment.”

 

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