10 things that must change at University Hospitals Birmingham after damning report

University Hospitals Birmingham (UHB) is facing fresh criticism after the latest review into how it is run was published.

The report, published yesterday (March 28) after a review of the UHB has revealed some major issues at the NHS Trust. The review took place after several organisations and leaders raised concerns of “bullying and poor behaviours at UHB”.

The Chair of Healthwatch Birmingham had previously released a statement raising concerns over bullying and patient safety at the Trust. Since then, the trade union Unison published its own review of concerns of bullying and poor behaviours at UHB raised by its membership.

Edgbaston MP Preet Gill, whose constituency includes the Queen Elizabeth Hospital site of UHB, wrote to the Secretary of State (SoS), Rt Hon Steve Barclay MP, raising issues relating to the culture at UHB and further concerns over safety at the Trust. Previously, the Parliamentary Health Ombudsman also had also criticised the UHB.

Now, NHS Birmingham and Solihull Integrated Care Board published the first of three reviews into University Hospitals Birmingham NHS Foundation Trust yesterday (March 28).

The review found a number of areas of concern, particularly with regards to leadership, culture and staff welfare and has made a series of recommendations for further action.

The review team made 17 recommendations, including these 10 priority actions:

1. A specific review of deaths related to blood disorders should be conducted by an external specialist in this field with support from a governance lead.
2. That appointments of senior medical, nursing, and managerial leadership are reviewed with a focus on developing core skills, including those required for leadership, collaborative working methods, professional interaction, and disciplinary processes.
3. In light of the tragic suicide of Dr Vaishnavi Kumar, a review of the processes to support doctors in training who are concerned about their mental health, improve their ability to speak up freely about concerns with colleagues and give a clear message that they will be listened to.
4. That the concerns of senior clinicians, expressed by the Medical Staff Committee in January 2023, are addressed specifically as part of the Phase 2 cultural review.
5. That the Trust commissions a partner to deliver awareness training on how to identify issues of bullying, coercion, intimidation and misogyny.
6. The Director of Medical Education to consider actions to counter the growing dissatisfaction of junior doctors in training - with the Trust Board to monitor the effectiveness of outcomes.
7. That the Trust reviews the role of the Freedom To Speak Up Guardian and offers all staff confidential and secure environments to report any past or current issues from which they have felt reluctant to come forward about.
8. That a ‘no blame’ culture is adopted and, when necessary, reinforced when whistle-blowers report concerns.
9. That the escalation process for clinical incidents and other areas of clinical risk is fully analysed from specialty up to Board level.
10. Neurosurgery: this review primarily focuses on the leadership and culture of the department this should include an assessment of the effectiveness and progress of the current neurosurgery development plan. To develop a fully effective recovery plan it seems likely to require significant ongoing external senior neurosurgical support.

The full report can be viewed on the University Hospitals Birmingham website.