HEALTH watchdogs say staff morale at a crisis hit Scots hospital was so low they “found people in tears” due to their frustration at not being able to provide patients with the best care.
They also uncovered claims of intimidation and by senior staff, problem areas being ignored and “significant deficiencies” in NHS Grampian’s running of Aberdeen Royal Infirmary which has led to a raft of changes.
The damning review by Healthcare Improvement Scotland (HIS) has also insisted on a 13-point recovery plan to urgently address the issues at ARI, warning patient care faces “serious impact” unless they are implemented.
And it highlighted numerous areas of concern surrounding the culture at the hospital, staffing and the attitudes of some senior staff, finding “significant deficiencies” in the way senior management at NHS Grampian ran things.
HIS said the board was “insufficiently aware” of several of the problems facing the hospital, specifically in relation to the emergency department which was said to be in a “developing crisis”.
While it praised the actions of “talented and dedicated” frontline staff, it also spoke of low morale in a number of departments, the “unprofessional behaviour” of some medical staff and “very poor relations” between some senior medical staff and managers.
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Dr Angus Cameron, chair of the review team and medical director at NHS Dumfries and Galloway, said the issues raised by the report are serious and described it as “sobering reading”.
He said: “I think the key message is we spoke to a lot of staff, over 500, and I was impressed by how emotional the discussion was.
“We found people in tears with their frustration at not being able to make Aberdeen Royal Infirmary work more effectively and that was because there was a lack of leadership, a lack of learning from when things had gone wrong and there was some completely unacceptable behaviour by senior medical staff that has gone unaddressed for too long.
“This is very de-motivating for other staff, we heard of consultants being highly unprofessional – intimidating and bullying other staff members – and a feeling of constant conflict amongst some of the senior doctors.
“I would stress it was only some, there is a silent majority of consultants up there who are highly professional and good people but if they are intimidated and over-ruled by a small number of consultants, you have a totally unworkable atmosphere.”
He added: “We’ve discussed with NHS Grampian what their actions [to address bullying] are going to be and we understand that they have formed a plan which will address all of the abnormal, unreasonable behaviours as well as addressing the weaknesses in management and improving the staffing levels.”
NHS Grampian said it accepted all the recommendations in the review of ARI and a separate HIS report into services for older people in acute hospitals.
New interim chief executive Malcolm Wright, said: “The board absolutely accepts the recommendations and detailed action plans have been drawn up to address these issues.
“We have committed to improving leadership, management and engagement between clinicians and managers at Aberdeen Royal Infirmary and across the organisation.”
However, RCN Scotland associate director Ellen Hudson said the Scottish Government could have done more to help earlier.
She said: “The Scottish Government should have recognised the problems in NHS Grampian earlier and taken action to address them. Surely this should have set alarm bells ringing in government and prompted them to take action sooner?”
Health secretary Shona Robison said: “There are clear failings highlighted that are simply not acceptable. Not least of these is a failure of leadership, a breakdown of relations with clinicians and the resulting pressures.”
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