Bullying and harassment in the NHS could be costing billions finds new research by MDX academic

24/10/2018
Bullying and harassment in the NHS in England could be costing the organisation over £2 billion per year, according to new research published in Public Money & Management

Dr Roger Kline, a Research Fellow at Middlesex University London Business School has co-authored a study which gives the first comprehensive estimate of the financial costs of bullying and harassment in the NHS. The study used data from NHS Digital to gauge the impact of bullying upon sickness absence, employee turnover, productivity, sickness presenteeism, and employment relations.

The financial cost of each of these factors was then combined to produce the overall figure of £2.281 billion per year. Of each individual component, sickness presenteeism was estimated to have the biggest financial impact. Described as the productivity lost when staff come to work while being bullied, and are more prone to making mistakes, presenteeism due to bullying was estimated to cost £604.4 million. This is double the cost of sickness absence because of bullying.

Study authors, Dr Kline and Professor Duncan Lewis from the University of Plymouth described the overall estimate as ‘extremely cautious’, as there are several costs that lack reliable evidence to gauge accurately, such as the impact upon spectators of bullying at work (who may need additional healthcare or counselling due to witnessing bullying), NHS reputational damage, and investigation costs for bodies such as the Care Quality Commission (CQC). The overall cost is therefore likely to be substantially higher than that reported in the study.

“We know in the health service that Boards rarely if ever discus the financial cost of bullying. Boards have some understanding of the impact on staff and on patient care and safety but our eye watering (albeit cautious) estimate should prompt NHS Boards to finally acknowledge this is a serious problem they have to address, especially at a time of immense financial pressures on NHS organisations.” Dr Roger Kline, Middlesex University

In the most recent NHS England staff survey, almost a quarter of staff reported being bullied or harassed by colleagues. In an extremely pressurized working environment under increasing strain from unprecedented demand and diminishing resources, there are pressing concerns about NHS staff wellbeing and patient safety.

Although policymakers increasingly regard reducing levels of bullying and harassment in the NHS as a priority, it remains a persistent issue, with little change in the levels of bullying reported for the past three years.

The  authors therefore hope that this research will give policymakers a crucial financial incentive to tackle bullying in the NHS.

Dr Roger Kline commented:

“We know in the health service that Boards rarely if ever discus the financial cost of bullying. Boards have some understanding of the impact on staff and on patient care and safety but our eye watering (albeit cautious) estimate should prompt NHS Boards to finally acknowledge this is a serious problem they have to address, especially at a time of immense financial pressures on NHS organisations.”

To address this serious problem, the authors suggest improving existing staff surveys to better capture the types of behaviours attributable to bullying, and to understand how staff feel about current procedures to tackle workplace bullying. With a better idea of the effectiveness of current strategies, improved methods could be developed.

In the longer-term, these improved methods would not only lead to a happier, more productive workforce, but also save vast amounts of money that could be directed elsewhere, to areas such as patient care.

Professor Lewis concluded: “Estimating the financial cost of bullying should not come at the expense of the moral reasons for tackling bullying and harassment. Nonetheless, if our paper means that NHS Trust executives realise the heinous costs of bullying, they may then think about where the additional resources currently wasted through bullying and harassment might be better deployed, which ultimately means more effective patient care.”

Click here to learn more about studying in the Business School.

Related stories:

In this section

Back to top