University of Surrey secures national grant to help address unprofessional behaviours between staff in hospitals

The study aims to help NHS managers identify both the causes of, and best ways to mitigate, unprofessional behaviours between staff. With the NHS staff survey identifying bullying and harassment as issues in many hospitals and ambulance trusts, the Surrey-led research aims to identify the best ways to tackle these behaviours, which can jeopardise patient safety, staff wellbeing and retention.

This study builds on previous research which has identified behaviours such as rudeness, overstepping boundaries, verbal aggression, sexual and racial harassment, and bullying. These unprofessional behaviours can affect all staff, but particularly those in ambulance trusts and staff members from minority groups.

Called a “realist review,” the research approach reviews the literature on this topic in a different way to other review methods by acknowledging the extreme complexity of the problem within the NHS. As such, the study aims to improve understanding of how, why and in what situations unprofessional behaviours can be best reduced, managed and prevented and to develop tools to help managers and others in positions capable of implementing change address unprofessional behaviours between staff. The tools will help identify which strategies are best to use to address specific types of behaviour within different staff groups. The team want to take an organisation-wide approach rather than focusing on individuals, as typically happens at present, and to ensure all types of unprofessional behaviour are tackled.

To undertake this important work, the University of Surrey has pulled together a team of experts in unprofessional behaviours, psychological safety and realist reviews. They will share the study findings with a stakeholder group which includes patient and public representatives, as well as healthcare staff with experience of facing unprofessional behaviours. This group will draw on their experience and knowledge to work with the researchers, helping boost understanding and dissemination of the findings. Together, they will design and develop evidence-based guidelines for NHS managers to reduce and prevent unprofessional behaviours.

Jill Maben, an expert in staff well-being at work and Professor of Health Services Research and Nursing in the School of Health Sciences, who is leading the study at the University of Surrey, said:

“Unprofessional behaviours can happen in any workplace, and as one of the biggest employers in the UK, it is not surprising that there is work to be done on this issue in some NHS Trusts. I am delighted that the National Institute for Health Research (NIHR) has commissioned this study to allow us to shine a light on these important issues in the NHS. We need to better understand what causes unprofessional behaviours, so that we can suggest solutions and make recommendations. It’s vital this study helps us better understand this important issue and produces the evidence-based guidelines for NHS managers to reduce and prevent unprofessional behaviours, thus changing the culture of parts of the NHS. In other aspects of our work, we provide important facilitated reflective spaces (Schwartz Rounds) to support students and newly qualified NHS staff to process any challenges at work and support well-being. These initiatives thus go hand in hand.”

Other members of the research team include: Dr Ruth Abrams and Dr Justin Aunger, School of Health Sciences, University of Surrey; Dr Mark Pearson, Hull York Medical School, University of Hull; Judy Wright, University of Leeds; Professor Russell Mannion, University of Birmingham; Professor Aled Jones, University of Cardiff; and Professor Johanna Westbrook, Macquarie University, New South Wales, Australia.

This project is funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research (project reference NIHR131606). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.