Section 32: Dignity at work

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32.1 To deliver excellent care to patients, all NHS organisations need to be well led and have healthy, supportive, positive cultures that value diversity and promote inclusion for all staff groups.  As part of this overall commitment, NHS organisations have a duty to provide an inclusive culture in which all staff have the right to be treated with dignity and respect at work, where bullying and harassment is not tolerated and where staff feel safe to speak out and discuss matters of concern without fear of reprisal.
32.2 For the purposes of this agreement, the following definitions apply:
At work - includes any situation that can be identified with either the requirements of the employer, or with social events linked to the same employment. It includes any place where NHS care is delivered.
Bullying - offensive, intimidating, malicious or insulting behaviour, an abuse or misuse of power which may undermine, humiliate, denigrate or injure the recipient. This can include “cyber-bullying” or other actions that may take place outside of the workplace but are linked to that employment.

Harassment - unwanted conduct affecting the dignity of staff  in the workplace that may be related to any personal characteristic of the individual e.g. age, gender, disability, religion/belief, sexual orientation,  ethnicity, pregnancy and maternity, marriage and civil partnerships, gender reassignment, political opinion or trade union membership, and may be persistent or an isolated incident.
In all cases of bullying and harassment it will be for the recipient to define what is inappropriate or demeaning behaviour.
Victimisation - Treating someone badly because they have taken action, or supported someone else to take action, under a policy relevant to this section.
Freedom to speak up – can include but is not limited to whistleblowing and duty of candour.
Bullying & Harassment
32.3 Bullying and harassment can have serious consequences for affected individuals and those they work with, reducing productivity and risking poorer patient care.  Therefore, employers should, in partnership with local staff representatives, draw up a policy statement informed by best practice.
32.4 The policy should apply to all staff, contractors and employees of other organisations who are on site, volunteers, visitors and patients at the point of service delivery and embrace the concept of zero tolerance.
32.5 It should be the responsibility of employers, through publication and promotion, to ensure that all concerned are aware of this policy and of sources of available support; that managers and staff are aware of the expectations which flow from the policy and what to do if these are not met. This should include, but not be limited to, appropriate training to support the promotion and application of this policy, including training for staff on how to challenge problem behaviours.
32.6 Managers have a responsibility to model the standards of acceptable behaviour expected of staff. They should ensure their own behaviour could not be construed as personal harassment by acting with fairness and equity. This includes using their judgement to correct standards of conduct or behaviour which could be seen as harassment, and to remind staff of these standards. Each member of staff carries responsibility for his or her own behaviour.
32.7 The policy statement should outline the organisation’s strategic response, including, but not limited to commitments to -
  • Working in partnership with staff side representatives on this issue
  • Identifying the nature and extent of bullying and harassment in the organisation
  • Consulting with staff, to listen and learn from their experiences
  • Set and publish a baseline goal and action plan for improvement
  • Evaluate progress
32.8 The procedure for dealing with complaints against members of staff should be seen as separate and different from the grievance procedure, and should recognise the difficulties being experienced by complainants.
32.9 It is recommended that there is a separate procedure for dealing with complaints by members of staff against patients, visitors or employees of other organisations.
32.10 The procedures should advise complainants that they may, if they wish, deal with their complaint informally, by directly (or with the assistance of a colleague) requesting the behaviour to stop.
32.11 All complaints should be taken seriously and investigated promptly and thoroughly.
32.12 The procedure for complaints against other staff members should ensure that: 
  • There are rights of representation similar to the grievance procedure and complainants should have access to trained advisers to help them to deal with the process of complaint;
  • there is specific provision to deal with cases where the alleged harasser manages, or is managed by, the complainant;
  • an alleged harasser has the right to be informed in writing of the complaint made against them.
  • Any formal investigation should be undertaken by a trained investigator operating outside their normal area of responsibility with a report produced for the responsible line manager who will determine the outcome and next steps.
  • Confidentiality should be maintained, as far as is compatible with thorough investigation and the effective handling of each case, and steps should be taken to ensure that complainants and witnesses remain free from victimisation
  • There is a right of appeal.
  • Appropriate action can be taken in the event of vexatious allegations being made
  • All complaints and outcomes are monitored, in partnership, to assist in the identification of the causes of harassment and bullying so as to inform any action plan.
  • No one should suffer victimisation as a result of making a complaint under the policy.
Freedom to speak up
32.13 The ability to discuss and/or report concerns openly without fear of reprisal or victimisation is essential in order for staff to play their important role in service improvement and driving up the quality and safety of patient care
32.14 Therefore, employers should, in partnership with local staff representatives, draw up a freedom to speak up policy statement and procedure for ensuring that staff can discuss and/or raise concerns without adverse consequences.  Such a policy statement should include the legal protection afforded to eligible whistleblowers, and take into account other statutory requirements and commissioning contract specifications.   It should also make clear the escalation routes for reports and lines of accountability.
32.15 Organisations that chose to appoint “guardians” or “champions” for this policy should ensure that they are recruited from all occupational bands and service areas, and reflect the diversity of the workforce.



Pay circular (AforC): 01/2019 amendment number 40

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