SOME consultants at Carlisle’s Cumberland Infirmary have accused their bosses of bullying them into putting targets above patient safety by asking them to move patients inappropriately.

After a period of intense winter pressure on services, senior A&E doctors from the hospital have reported that they have been left fearing for their professional reputations should there be a serious incident.

The medics have complained about “incessant calls” from senior managers which have impacted on their ability to properly do their jobs.

Officials from the British Medical Association (BMA) – the country’s trade union for doctors – described the reports as “troubling”.

Managers at North Cumbria Integrated Care NHS Foundation Trust, which runs the Infirmary and Whitehaven’s West Cumberland Hospital, insist that they will challenge any unacceptable behaviour and say they aim to put clinicians at the heart of decision making.

The bullying allegations surfaced in documents published for the trust’s board meeting last month.

A report described how the concerns were first raised after the Infirmary’s A&E department was visited by Katherine Henderson, president of the Royal College of Emergency Medicine.

Summarising the outcome of the visit, the report said: “The consultants at the Cumberland Infirmary reported high pressures from poor [patient] flow through the organisation, which is adding to their workload.

“They were concerned for their professional reputation and registration in the event of a serious incident.

“The also reported that they and colleagues in the department felt they had been bullied by senior managers to move patients inappropriately, to re-prioritise work, to prioritise 12 hours ahead of quality and safety.”

The report added: “There had been incessant calls from senior managers asking for information and actions which was impacting on their ability to do their jobs properly.”

The General Medical Council (GMC) has confirmed it will now begin “enhanced monitoring” at the trust after junior doctors alleged there was widespread bullying and harassment.

Health Education England formally requested that the General Medical Council (GMC) take action after 12 first year doctors reported being subject to or witnessing bullying and harassment, including coercive behaviours, by clinical and non-clinical staff.

It has been suggested that the General Medical Council (GMC) may now begin “enhanced monitoring” at the trust.

Dr Rob Harwood, chairman the BMA’s consultants committee, said: “The concerns raised by senior doctors at the North Cumbria Integrated Care NHS Foundation Trust are extremely troubling.

“That some consultants have reported feeling pressured or bullied into putting targets above patient safety is unacceptable and the BMA is ready to support any doctor who refuses to compromise the care of their patients.

“The BMA is committed to stamping out all forms of bullying in the NHS and will provide support to members who are being bullied, harassed or who want help in raising concerns.

“What’s more, this case further highlights the impact that more than a decade of underfunding has had on frontline NHS services, with some trusts seriously lacking the capacity and resources to be able to meet rising demand.

“In the face of these pressures though, patient safety must always be the priority and doctors need to be able to use their professional judgement to deliver the care they deem appropriate, while also being supported to raise any concerns without fear.

“We hope the recent changes in the senior management team at the trust will help urgently address these serious issues to ensure the future safety of both staff and patients.”

The organisation’s junior doctors committee chairwoman Dr Sarah Hallett said: “It is hugely concerning that so many foundation year trainees at the trust had either been subject to or witnessed bullying or harassment; as well as clearly being distressing for that individual, such behaviours can seriously impact on patient care and the quality of doctors’ training.

“Junior doctors often work some of the longest and most intense shifts in a hospital, providing vital care to patients. A recent BMA survey found they are also more likely to suffer from burnout or stress.

“At a time when the NHS is under more pressure than ever before, it is essential that doctors in training are given full and appropriate support and that bosses encourage a culture of openness and learning among staff, rather than one of blame. This is crucial if we are to safeguard our staff and patients in the future.”

In its board meeting papers, the Trust’s medical director Vince Connolly said managers were appreciated the work of A&E staff and that “actions” were in place to address their concerns.

A trust spokeswoman said: “We are currently working with Health Education England to improve the support and experience of our doctors in training.

“Following their visit, we have already taken steps to improve and strengthen the hospital at night team and the handover process to ensure better support and supervision for our trainees.

“As a newly merged trust our new Chief Executive has work in hand to create a better place to work for all of our staff which includes challenging unacceptable behaviours.

We are reporting directly to Health Education England in relation to this which will also improve the quality, safety and experience of our patients.”

Last month, the trust declared an Opel 4 alert – meaning the hospital could not provide comprehensive care and there was increased potential for patient safety to be compromised. It was the fourth such alert in two months.

The new Chief Executive has vowed to put clinical leadership to the forefront of how the organisation will make decisions.

Lyn Simpson said: “Empowering our doctors, nurses and allied health professionals to make more of the decisions about how we manage our resources and deliver care across our hospitals and services is hugely important.

“Following the creation of North Cumbria Integrated Care in October 2019, we need to make sure our clinicians are at the heart of the decisions we take as an organisation.”

Professor John Howarth, the trust's Deputy Chief Executive, said: “Lyn is now inviting our clinical leaders to take the opportunity to work hand in hand with the leadership team to ensure that quality and safety drives the organisation in the future.”

A GMC spokesman said that "enhanced monitoring" allows the regulator to engage with organisations to address concerns about their training to find a sustainable solution. When serious concerns are not fully addressed, the GMC can place conditions on its approval of the training programme to help ensure standards are met.