Investigating the Investigators – how the NHS can better tackle workplace issues

The NHS often looks to tackle workplace conflicts and allegations of misconduct with formal investigations. However, there has been almost no scrutiny of why these investigations are authorised, how they are conducted and crucially the impact they have on the wellbeing and mental health of the staff involved as well as the impact on staff behaviour, workplace culture and patient care. It was time to turn the tables and ‘Investigate the Investigators’ - the title of my new report.

Prior to my role as a research fellow at Middlesex University, I held senior positions at eight different trade unions. I have extensive knowledge and experience of workplace culture, particularly focused on the NHS. My most well-known report ‘The Snowy White Peaks of the NHS’ addressed racism in the health service.

My professional and personal life is guided by a sense of shared justice and social humanity. In this new report I looked at literature around workplace investigations in the NHS, surveyed 126 people who have been subject to investigations and carried out in-depth interviews with investigators, commissioners, HR lawyers and trade union representatives.

Perhaps the most damning verdict came when those surveyed were asked for their opinion on the conclusion of investigations. The vast majority said they were ‘very dissatisfied’ when asked for their view on the confidentiality of the investigation, the conduct and impartiality of the external investigators and the quality of the final investigation report.

During my research, some major issues emerged. One of these was it was often felt that the investigations were ‘weaponised’ and used to punish staff.

“The investigator seemed more interested in why I had raised these concerns rather than getting to grips with a serious breach of trust values,” said one senior nurse.

“When I complained, they had to do another investigation into my specific concerns. A complete waste of money. And the advice they got from NHS England was hopeless.”

A senior clinician said: “When I appealed the extraordinarily vague outcome that rejected my grievance, I was told ‘I couldn’t, as the investigation was at the first informal stage’ so I had to relive everything again.”

One project manager likened the investigation to a “fishing trip, not a forensic interview”.

A finance director said: “I know the new HR director persuaded the chairman that I was a troublemaker and should be investigated. I was then suspended on the basis that there were issues with finance. There were indeed – the very ones I had tried to tell the chairman about.”

There were prevalent concerns about the use of external investigators, and whether they were impartial.

One stated: “They say they’re independent, but they’re paid by the trust. It’s hard to believe they’re not trying to deliver what the employer wants.”

My research found there needed to be more accountability and clear guidance on the standards of the workplace investigations. And we need to always consider the impact on patient care.

It was troubling to hear how the investigations often failed to understand bias, discrimination and how racism could be a factor.

A lead in equality, diversity and inclusion (EDI) even told me: “Instead of dealing with racism effectively, we get nothing or we get a formal investigation in which there is pressure to refer to ‘poor behaviours’ or  ‘misunderstandings’ rather than actually name the form of discrimination.”

One interviewee stated: “He just didn’t understand what institutional racism looks like. He treated it like a personal disagreement rather than a structural issue.”

A senior HR manager said: “I’ve found the levels of understanding of discrimination – especially disability and race - were pretty chronic on the whole.”

An EDI practitioner told of how she complained when she learned a director had shared naked images of themselves on a WhatsApp group, but it was dismissed as ‘clinical humour’.

“I learned how ruthless an employer can be and how useful a shoddy investigation can be to such an employer,” she said.

“I am an Asian woman, and the entire senior management team are white. The investigation rejected my allegations. Other BME staff were outraged. I became ill as the cumulative impact of my treatment wore on and left.”

For members of staff, the damage to their health and career could be long-lasting. More than one interviewee told of how their marriage had fallen apart (or nearly done so) under the stress.

In my report I made a number of recommendations that the NHS should take into considerations with workplace investigations., These include:

• Employers should avoid pursuing a formal investigation into workplace conflicts unless there are no other options.
• Employers must consider what is the purpose of the investigation and who does it benefit - the individual, the team, the organisation or patient care?
• There must be accountability for those who commission, undertake, advise on, and consider the findings of investigations
• Organisations should not underestimate the risk of making the investigation itself a punishment
• Employers should reduce the reliance on external investigators and to be especially cautious about those external investigators whose short-term commercial interests might not coincide with the values and priorities of the NHS.

Read the full report and a summary of my findings.

You can find out more about my background with this interview with the British Medical Journal (BMJ).