Bullying is widespread within the UK's National Health Service

Bullying is widespread within the National Health Service, and can have serious consequences. It can significantly decrease job satisfaction and increase job-induced stress; it also leads to low self-confidence, depression, anxiety and a desire to leave employment.

Bullying contributes to high rates of staff turnover and sickness absence, impaired performance, lower productivity, poor team spirit and loss of trained staff. This clearly has implications for the recruitment and retention of NHS staff.

Research shows that Black and Asian doctors are more likely to be bullied. To date, no study has looked at bullying amongst psychiatric trainees.

In this survey, published in the June issue of the Psychiatric Bulletin, postal questionnaires were sent to all psychiatric trainees on the basic and higher psychiatric training schemes in the West Midlands. The questionnaire collected demographic details; asked whether the respondent knew where to obtain help, or whom to contact, if they were bullied; and assessed bullying behaviour.

Behaviours were grouped into sex categories: threats to professional status; threats to personal standing; isolation; overwork; destabilisation; and discrimination on the grounds of race or gender. Only Senior House Officers and Specialist Registrars were included in the survey.

Of the 232 doctors eligible for inclusion, 76% returned completed questionnaires. 53% were male; 65% were SHOs; 39% were White and 51% Asian; and 56% were foreign doctors training in the UK.

Overall, 47% of respondents had experienced one or more bullying behaviours in the preceding year. 28% of those doing the bullying were non-medical staff; 27% senior medical staff; 20% patients; 16% managers and 9% peers. 46% of respondents said that they knew whom to contact in the event of bullying.

A total of 401 individual episodes of bullying behaviour were reported in the preceding year. On 92 occasions action was taken. 31 had a positive, and 61 a negative, outcome. Foreign doctors were significantly less likely to take action about the bullying than local doctors (on 32 v. 60 occasions).

The authors of the study comment that this survey confirms that bullying of junior doctors is prevalent in the NHS, and shows that psychiatric trainees are not exempt. Those who are bullied are often unsure how to access help, and when they attempt to do so the results are often unsatisfactory.

Foreign trainees may have a great deal invested in completing their training in the UK, and may be particularly reluctant to ‘rock the boat’ and risk alienating those on whom they depend for references.

Trusts need to be more proactive in preventing bullying and offering dedicated support to victims. One of the strengths of psychiatric training in the UK is the regular supervision given to trainees, and this may represent an opportunity for addressing bullying behaviour and providing such support.

Legislation is urgently needed in the UK to protect those who are bullied; and significant changes are required at a national, organisational and individual level to raise awareness of, and tackle, the problem.

For further information or a press copy, of the full article, contact Deborah Hart or Thomas Kennedy in the External Affairs Department. Tel: 020 7235 2351 exts. 127 or 154. E-mail: [email protected]