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A&E nurses at Arrowe Park hospital feel bullied, let down and forced to compromise on care, a leaked report reveals.

Independent researchers found many claims of “totally unacceptable” behaviour, evidence of “tribal divisions” and junior staff “set up to fail” by being put in under-resourced teams.

Ward teams were even accused of hiding up to 50 beds a night from A&E nurses who wanted to get patients admitted swiftly to ease pressures on A&E.

The report by thiNKnow said behaviour had gone unchallenged and criticised bosses, HR teams and even “the majority of staff” in A&E for not doing more to prevent it.

The report recommended a clampdown from now on but said no action should be taken over past behaviour because those responsible were “products of an environment”.

The document was leaked by a staff member after trust bosses repeatedly failed to make it public to the ECHO - despite a stated commitment to openness and transparency.

Staff bullied and “set up to fail”

A small number of staff were accused of consistent bullying over a long period - and this reportedly “set a standard” for many others to behave badly without fear of consequences.

Some nurses were “set up to fail” by colleagues who allegedly arranged rotas to ensure some teams were deliberately smaller and less well-trained.

Newly promoted sisters suffered from a long-running “pattern of bullying”, such as being publicly undermined, aggressively challenged and denied responsibilities and information.

The department suffered from “tribal divisions” and behaviours as well as rigid hierarchies and cliques among staff, which were creating “obvious fractures” in their relationships.

The report was commissioned after an anonymous letter highlighting a bullying culture in A&E was sent to a top trust official.

Bad behaviour “unchallenged” by bosses

Researchers at thinNKnow accused bosses of poor management after concluding “nothing seems to be done to change anything” about bad behaviour and performance.

They said negative behaviour had been allowed to go unchallenged, with staff seeing there were no repercussions and enjoying “passive permission and at worst inadvertent encouragement” to behave poorly.

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Some staff broke down as they opened up to the researchers, but others made “unedifying comments” about colleagues even in their interviews.

The researchers were concerned that none of the staff accused of bullying “demonstrated any insight into their behaviour” when giving evidence.

Staff pressured to compromise and ward beds deliberately “hidden”

Many staff said they felt let down, unsupported, unvalued and could not remember the last time they were thanked for their efforts.

A&E staff even felt “under huge pressure to compromise” on care and standards and felt unrelenting stress over the level of demand.

Emergency department staff also reportedly faced rudeness and irritation from teams on wards when trying to hand over A&E patients or get ward beds freed up.

The consultants said ward teams “don’t seem to recognise their part” in meeting four-hour targets for admitting or discharging patients.

Ward teams were even accused of hiding up to 50 beds a night to delay admissions from A&E - with the emergency matron forced to walk around looking for them in the evening.

But the report did praise the care they observed by staff in A&E, with effective teamwork “despite rather than because of” the way it was managed.

Every single staff member also told interviewers they would send their loved ones to the hospital.

Has the hospital been “open and honest” about the report?

The hospital trust’s acting chief executive David Jago said transparency and an “open and honest culture” were vital in a recent email to staff after the former chief executive’s sudden departure.

The trust has been open about some of the challenges facing the hospital, but the ECHO has struggled to get answers and transparency over this report.

The ECHO first asked the hospital for the report in December after a tip-off.

A hospital spokeswoman said at the time no details could be released as the probe was ongoing.

A request for a copy was then submitted under the Freedom of Information Act, which meant the hospital had a legal obligation to release it - unless it could provide a reason why it should be exempt.

The hospital failed to provide a response by the January 24 deadline.

The ECHO asked both the media and information teams again for a copy earlier this month, but it was not provided.

It is now almost a month since officials should have responded to the formal request under freedom of information laws - but it has still not handed over the document.

What NHS chiefs are doing about the problems

The hospital is already under investigation by NHS Improvement, in a probe into senior staff’s concerns about how well the hospital is run and how sexual harassment claims were handled.

Former Arrowe Park chief executive David Allison stood down suddenly last month after colleagues reportedly accused him of aggressive behaviour and a “lack of grip” on the organisation.

But Dr Susan Gilby, who joined the trust last year, has promised “cultural change” to stop bullying or harassment at the Wirral University Teaching Hospital trust, which runs Arrowe Park.

She has also apologised over a culture of bullying and harassment after further claims came out in a recent staff survey.

David Jago told the ECHO today: “As soon as concerns were raised with the Executive Team we acted immediately and commissioned an independent review in our Emergency Department, recognising the current challenges we are facing.

“We are now working with colleagues in our Emergency Department to address the issues raised and to move forward in a positive way.

“Our senior team are fully supporting colleagues throughout this entire process.

“We thank staff for their participation in this review as this will help us to identify areas where we need to improve.

“As always our priority is to ensure safe, high quality patient care is at the heart of everything we do.”