NHS Highland will no longer receive extra government support in leadership, governance or culture, following improvements after the Sturrock review.

The board was initially escalated to Stage 3 of NHS performance escalation framework in 2018 following concerns of a culture of workforce bullying and harassment.

An independent report by John Sturrock QC, commissioned by the Scottish government, confirmed “fear, intimidation and inappropriate behaviour” and called for wide-ranging changes.

The Healing Process was created in repsonse, with an independent review panel established to speak to victims of bullying and come up with recommendations for the health board to make improvements.

A total of 272 current and former NHS Highland and local health and social care partnership staff provided testimony between 2019 and March this year, with more than £2.8m paid out to those affected by bullying.

Concerns were raised by some of the first people to go through the healing process that the system was “broken” and many victims could end up “bitterly disappointed”.

The board has also established systems and processes to allow colleagues to speak up in the wake of the Sturrock Review, including an independent Guardian Service and staff training in Courageous Conversations.

NHS Highland was handed oversight of its own escalation and de-escalation, rather than a Scottish government-led oversight group, in November 2021.

Following a letter of assurance from the board chair earlier this year, the Chief Executive of NHS Scotland, Caroline Lamb, agreed to the de-escalation in September.

Independent progress tracking shows the board has delivered significantly against many actions laid out by the review but the board concluded in its final June update that ‘culture change is not yet embedded at all levels of our organisation’.

In August last year, 233 NHS Highland or Argyll & Bute HSCP surveyed staff reported that they were still being bullied or harassed at work.

NHS Highland says the de-escalation reflects the 'clear roadmap' to ongoing process:

'This is welcome recognition of the hard work that has gone in to securing improvement in these areas so far, and also reflects the fact that we have a clear roadmap to ongoing progress. Every organisation must always be constantly striving to improve its culture and leadership and we will continue to focus on this area.'

In a statement today explaining the decision to deescalate the level of support for the board, the Cabinet Secretary for Health, Humza Yousaf, said he is pleased that NHS Highland has acted on the recommendations for improvement:

“I welcome the progress that NHS Highland has made, and the reassurance the board has given, over the improvements made since the escalation was introduced. I would also like to thank the staff for their work to deliver the changes that will make working in health care services across the region better.

“I know the toll it will have taken on those who came forward to the Independent Panel and Sturrock Review to voice concerns on a culture of bullying in the board. I want to repeat my thanks to all who took part, and to everyone working to make an improved and more supportive environment so the best level of care can be provided.

“The board has acted on the recommendations of the review and is committed to working to embed these improvements.”

NHS Highland says all colleagues and managers need to play their part in local transformation, which will be taken forward in its five-year ‘Together We Care’ strategic plan published last month.

The board continues to face challenges. It will remain in Stage 3 escalation over its performance in both mental health and finance.

According to a June board meeting paper, NHS Highland faces a £42.4m financial gap this year.

The board has "typically struggled" with an overreliance on non-recurring savings, according to a partner at external auditors Grant Thornton, though assistance from consultants at PwC has helped the board hit more of its financial targets in recent years.

NHS Ayrshire & Arran and NHS Borders are also currently in receipt of additional financial guidance and support from the Scottish government.

The Scottish government says it will continue to work with the board to improve services further, particularly in the face of the huge challenges created by the pandemic and going into winter.

 

Read more: NHS Highland compensates almost 200 bullying victims; Highland bullying victims question ‘healing process’; Highland healing process deadline pushed back

 

 

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