The UK's biggest mental health NHS trust, which covers Broadmoor Hospital and units looking after the most vulnerable female patients, is in turmoil following widespread allegations of bullying, a critical Care Quality Commission inspection report and the sudden resignation of its chairman.
Nigel McCorkell, chairman of West London Mental Health NHS Trust, has unexpectedly resigned more than two years before the end of his term. Mr McCorkell, a chartered accountant, was reappointed for a second fixed four-year term in January 2013 but recently announced his retirement. He told staff he was stepping down because his term was due to end before the trust could achieve the "significant milestone" of achieving foundation status. Mr McCorkell said: "As a result, I have decided the best course of action is to retire now and make way for a new chair to see the trust through this critical next phase of its development."
It comes after the trust was criticised by the CQC health watchdog which found that the 124 complaints made to the independent regulator between August 2013 and July 2014 were more than four times the number expected, placing the trust in "elevated risk" in this category. The watchdog placed six further aspects of its work as at risk, including deaths of patients detained under the Mental Health Act, fairness and effectiveness of incident reporting procedures, food and facilities. There were 49 categories where "no evidence of risk" was found.
Out of 51 mental health trusts, West London, which employs 3,160 staff serving about 700,000 people, has the worst record for staff experiencing violence both from patients and colleagues, according to official NHS staff surveys in 2012 and 2013. Thirty per cent of staff experienced harassment, bullying or abuse from other members of staff in 2013 and just over one in four (26 per cent) experienced discrimination. Almost one in 10 (8 per cent) employees experienced physical violence from colleagues, double the national average for the mental health or learning disability trusts.
The trust has also been heavily criticised by a whistleblowing charity for pursuing a former employee who lost her case last month after speaking out about the culture of bullying and bad management she believed was proving detrimental to patient care. Dr Hayley Dare was sent a letter from the trust's lawyers last week applying for £93,500.70 tribunal costs against her, claiming she had acted "vexatiously, abusively, disruptively or otherwise unreasonably" after she raised safety concerns.
The trust, which made a £5.6m surplus last year, is pursuing Dr Dare for the costs of her failed claim. The former clinical lead of women's forensic directorate and consultant clinical psychologist at the trust claimed she was bullied for speaking out against poor patient care and staff welfare. She lost the case last month because, according to the tribunal, she had not made her disclosures "in good faith", a provision that whistleblowers no longer have to satisfy following a parliamentary amendment last year.
Dr Dare, who had an unblemished 20-year career in the NHS, followed the trust's whistleblowing policy and took her claim to trust chief executive Steve Shrubb in March 2013. She fell sick with anxiety and severe depression after speaking out and took time off work. She discussed a gradual return after an approved period of annual leave and was told this would be subject to an assessment. Soon after she was sacked in a three-line email. Two weeks before her employment tribunal began she was told: "Your redundancy package will be in your bank account by Monday."
The Watford Employment Tribunal ruled Dr Dare had not made a protected disclosure and dismissed her case. "Bringing a whistleblowing claim against the trust was never about money – it was only ever about patient care. Nobody in their right mind would go through this kind of process for their own self-interest," she said.
Dr Dare, a single mother of two, said she was left "paralysed" by the demand and has vowed to fight it.
She said: "I felt complete fear when the letter arrived. It has paralysed me. If this doesn't terrify anyone from speaking out in hospitals ever again I don't know what will. It's clearly a warning to anyone thinking of being a whistleblower."
Cathy James of the whistleblowing charity Public Concern at Work said the "in good faith" provision was no longer required in whistleblowing cases. "That was a real weapon trusts could use so they could argue their case against you, saying your motive was bad and you were out to get your manager, rather than against the issues you have raised. That's what [Dr Dare] has come up against. This is why we lobbied really hard for it to be removed and it's a real shame it has been used against someone in a recent case."
She criticised the trust for its "despicable behaviour" in pursuing Dr Dare for costs."What a waste of public money. I think it's despicable," she said. She added that the case will have "a huge chilling effect on people speaking out". "Who is going to pursue anything? How are we ever going to change the culture if this is how our public authorities behave?" she said.
Andrew Gwynne, Labour's shadow Health minister, called on Jeremy Hunt to look at the case. He said: "It has the potential to dissuade other whistleblowers from coming forward. That would be extremely damaging for the NHS. As the NHS heads downhill under this Government, staff must feel supported to come forward with any concerns."
A trust spokesperson said it was on "a journey of improvement". "As Steve Shrubb, chief executive, told the tribunal, the trust had a history of poor results in the staff survey and the improvement of the internal culture had become, and remains, a key priority for the trust in moving forward. The leadership has already made significant progress in bringing about real change to the culture within the trust. Work is under way to address areas [identified by the CQC report], and the trust is using the information contained in the report to further improve the quality of the care and treatment we provide to those who use our services.
"The tribunal made it clear that the forensic service had acted on concerns raised about patient care. The trust is continuing to improve the quality of its care by creating a clinically led service. The trust spent £93,000 of taxpayers' money defending this case. We are trying to recoup our costs on behalf of our patients and in the interest of taxpayers."
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