Health
Doctors’ Lack of Belief in Management
The survey was sent to more than 160 doctors last month, with 72 respondents (43%)
A survey of doctors working at Noble’s Hospital has found that 79% of respondents think that the organisations lacks strong leadership.
The ‘Culture of Care Barometer’, designed by the NHS and Kings’ College London, on behalf of the Island’s doctors, was sent to more than 160 doctors last month, with 72 respondents (43%).
The British Medical Association has said that the results show a persistent culture of poor senior leadership, doctors not being treated with respect, poor behaviours not consistently tackled, and doctors not having the resources or time they need to treat patients as well as they want to.
Manx Care has said it welcomes the report, saying it ‘provides a very helpful snapshot of the opinions of those employees’, whilst also pointing out Manx Care employs ‘almost 3,000 people’.
Of those who responded to this year’s survey, a total of 66% said they either disagreed or strongly disagreed with the statement that they felt well informed about what was happening within the organisation. When they were asked if there was ‘strong leadership at the highest level’ in the organisation, 3% agreed there was, but 46% strongly disagreed and 33% disagreed.
Just 21% agreed and only 1% strongly agreed, with the statement, ‘The organisation has a positive culture.’ However, 44% of those who responded felt that the people they worked with were friendly and that when ‘things get difficult’ 44% agreed they could rely on colleagues to help them. But when it came to addressing poor behaviours, 60% disagreed or strongly disagreed with the statement that ‘unacceptable behaviour is consistently tackled.’
One doctor said: ‘It is a bad culture, and I am unsure how it can be fixed. There is an interesting hatred for doctors I have not experienced anywhere else.’
The Chair of Council for the BMA, Professor Philip Banfield said: ‘On my recent visit to the Isle of Man and afterwards, doctors told me of the anger, dismay, and distress they felt about not just Dr Ranson and her treatment, but about the culture of the health system more widely.
‘This latest barometer shows little improvement and far from the figurative needle rising, it continues to be in a deep trough of poor morale and poor communication. This is not an environment any doctor should have to work in and I’m really glad that we are now able to discuss and plan improvement and change in an open and transparent manner.
‘Culture and civility in work are directly linked to patient safety. Standing with doctors in the workplace to help them organise and make collective positive change is something the BMA has prioritised – we are here to help, but first there must be a true recognition and acceptance that there really is a problem here that needs fixing, and it needs the medical workforce to be better engaged in providing the care that is so important to the patients of the island.’
Dr Prakash Thiagarajan, chair of the Isle of Man Medical Society, added: ‘The results of our Culture of Care Barometer again raise issues with the culture of Manx Care and the problems doctors face when caring for our patients. We hope that this survey, along with the recent spotlight shone on health services following the appalling treatment of Dr Rosalind Ranson, is a watershed moment that will deliver positive change.
‘It is now more important than ever to build a culture based on trust and transparency. This requires us all to be honest about the challenges ahead. Manx Care must now engage in an open manner with doctors and other staff to create an open culture where we are empowered to raise concerns if we have them. Only by doing this can Manx Care improve our working lives, as well as the care provided to patients.’
Manx Care
For its part, Manx Care addressed most of the issues raised. On the matter of a lack of resources, the island’s health and social provider said this is something it is ‘acutely aware of and have been working in partnership with the Isle of Man Government to address’.
It said: ‘Manx Care has taken significant steps over the last year to address its long-standing and hard-to-recruit vacancies, and many posts are now filled substantively. Our international Nurse recruitment has also been successful, with many long-standing nursing vacancies also filled.
‘Along with the entire health and social care system internationally, staffing shortages remain, and we are relentless in our focus and commitment to addressing this.’
The arms-length organisation said that there that are positives in the report, which point progress, albeit slow progress, is being made.
The report found that more doctors felt they were able to influence the way things are done in their team than didn’t. However, this does not extend further up the chain to higher levels of management.
It also found that most doctors thought their line manager treats them with respect, that they know exactly what is expected of them in their jobs and that they get the training and development they need.
They also said that they can rely on their colleagues during difficult times and that they are able to ask for help when they need it.
Manx Care added: ‘We recognise that the development of a healthy culture will always be a work in progress, and that we still have a way to go in order to establish and fully embed the culture we wish to see within all areas of our organisation. Equally, we recognise that there are areas within the organisation or certain staff groups where cultural challenges are stronger than others.
‘Changing the culture of our organisation will not happen overnight. There are a number of things which tell us that we’re moving in the right direction, including feedback from the Care Quality Commission (CQC) inspections held during the last year, and from the Partnership Working Forum that we have established with our Staff Side representatives which meets monthly.’
Gef’s Take
Not something we do too often these day, but both the BMA and Manx Care take such different angles on this, it is hard to find a middle ground.
Looking at the survey results, it seems that doctors feel they trust and respect their immediate team and leaders, but have a disconnect with those further up the food chain.
Find the full report here:
