The Effectiveness of Anti-bullying Policies within the NHS: An Empirical Investigation

Based on the definition of Einarsen and Skogstad (1996), workplace bullying is defined as follows: “A person is defined as bullied if he or she is repeatedly subjected to negative acts in the workplace. However, to be a victim of such bullying one must also feel inferiority in defending oneself in the actual situation. This definition builds on research on bullying in the school playground… and stresses that bullying and harassment imply a difference in the actual or perceived power and ‘strength between the persecutor and the victim.

Typically, a victim of harassment or bullying is teased, badgered, and insulted and perceives that he or she has little recourse to retaliation in kind…This definition…is not limited to a predefined set of negative acts. It covers all situations in which one or more persons over a period feel subjected to negative acts that one cannot defend oneself against. Even if a single episode, e. g. physical assault may be regarded as bullying or harassment, this definition emphasizes ‘repeated negative acts.

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’ Consequently, serious conflicts between parties of ‘equal’ strength, or isolated episodes of conflict, are not considered as bullying. (p. 187). The NHS represents a very important entity in the delivery of healthcare services. And as bullying represents an important work place condition variable that may affect the quality of services delivered within the organisation and to patients, it is but logical to conduct a study on bullying within the NHS. Review of Related Literature O’Hare (2006) reports that there were about 5 thousand nurses attacked while at work in Northern Ireland in 2005.

A handful of the victims suffered fractures, still others were grabbed by the throat, or subjected to insulting behavior such as being spat at. More than 60% of those surveyed underwent verbal harrassment as well, while about 27% were physically abused (O’Hare, 2006). These figures take on greater importance as we consider the scarcity of healthcare workers who are expected to deliver quality healthcare to NHS patients. Why is it crucial to emphasize civility in the workplace? The cuthroat competition of contemporay organisation necessitate that they develop strong retention factors that will motivate their employees to stay.

It has become increasingly difficult to make employees stay within an organisation for long, and one important factor that influences such a decision is the environment of hostility vis-a-vis civility within that workplace. More often than not, employees choose to transfer to other companies instead of taking in such working conditions (Glendinning, 2001). NHS’ Definition of Bullying Bullying is defined within the NHS Trust as follows: "Persistent, offensive, abusive, intimidating, malicious or insulting behaviour, which amounts to an abuse of power and makes the recipient feel upset, threatened, humiliated or vulnerable.

Bullying undermines a victim's self-confidence and may cause them to suffer stress" (NHS Anti-bullying policy, 2002, p. 1). The NHS Trust likewise acknowledges that the occurrence of bullying within the workplace results in undue stress, depression, decrease in self-esteem, undesirable performance, and ineffective dealings with others (NHS Anti-bullying policy, 2002). Definition of Bullying by the NHS Trust The UK is not alone in its struggle to protect its workers from bullying. In a study by Glendinning (2001), they studied this phenomenon within an organisational context.

Through a comprehensive review of related literature, they have conlcuded that a new relationship between supervisors and subordinates have evolved, and rightly so with the increasing dynamism and competition in the new global village (Glendinning, 2001). Moreover, it prescribes that the human resource function be held most accountable for curbing such occurrence. Difficulties in Deploying Anti-bullying Policies Glendinning (1999) differentiates between a “bullying” superior and a hard to please one. The latter simply sets out stiff expectations and targets from his subrodinates to be able to optimize their performance.

On the contrary, this is not the intention of a bullying boss (Glendinning, 1999). He proceeds by consistently showing aggressive behavior that causes either physical or psychological harm to the staff he supervises . Some of the repercussions of bullying behavior in the workplace are turnover, retention, recruiting and succession issues, employee health effects, reduced productivity, counterproductive behavior, and legal countermeasures by employees (Glendinning, 1999). Prescriptions for HR Professionals for Creating a Bully-free Workplace

According to Cox (2005), 87% of those in the human resources funtion were keenly informed of bullying occurences within their company. This may be a disturbing finding considering that despite such awareness, there are still 19 million working days lost because of this phenomenon. In fact, the figures show that out of five employees, there is one who is likely to feel stressed from this cause. Stress, in itself, incurs substantial cost at 7 billion annually (Cox, 2005). There has been difficulty of monitoring bullying incidents, primarily because some or even several incidents go off unreported.

While there are preponderant anti-bullying policies, there is a dire need for training so that there may be heightened awareness on observing the indicators of bullying. If the bad treatment is rooted on ostracism, the employer may even be held liable for the action. Currently, employees have something more solid to rely on as a result of the Majrowski v Guy's & St Thomas's NHS Trust case. Mr Majrowski contended that his employer was partly accountable for the acts of an employee and asserted that he did experience bullying, harrassment, and intimidation from his superior.

He likewise experienced extreme criticisim and others were favoured over him. As a result, the Court of Appeal rules in his favour and explicitly prescribed that he could depend on the Act and that the NHS was accountable for the actions committed by the employee (Cox, 2005). This decision has accorded employee’s a novel right, including definitions and entitlements relatd to harrassment and anxiety (Cox, 2005). There are several recommendations put forth for human resource professionals to be able to promote a bully-free workplace.

One such proposal is to establish standards of interpersonal behavior within the organization to be able to (Pearson, Anderson, & Portah, 1999). Spelling out these expectations early on clearly lay down what is considered desirable or undesirable behavior within the company. Next is to be able to convey a clear message on the organization’s stance on bullying and its corresponding policies. The first realm which may exert an influence on this phenomenon is the recruiting function which may relay these messages to prospective employee early on during the onboarding process (Pearson, Anderson, & Portah, 1999).

The policies related to bullying must also be clearly reflected onto the employee’s job description, and there should be emphasis on the repercussions of violating these. Flynn (1999) also recommends that these behaviors be included as criteria for evaluation during the performance appraisal exercise. Given this backdrop, the current paper proceeds with an empirical investigation of bullying within the NHS Trust. The primary aim to to put forth recommendations on how to increase the efficacy of its anti-bullying policy, resulting in increased retention among its nurses and medical staff.

Problem Statement The present research intends to address the following problem: How effective is the drafting and deployment of anti-bullying policies within the NHS? Thus, to be able to respond to this question adequately, the following questions have been investigated: 1) To what degree does bullying behaviour transpire within NHS hospitals as perceived by nurses / midwives / health care assistants and student nurses? 2) What is the efficacy level of the NHS anti-bullying policy as perceived by the medical staff? 3) Is there a significant relationship between the following variables?

a) Degree of bullying behaviour experienced and level of efficacy of the NHS Bullying Policy? b) Degree of bullying behaviour experienced and age of the medical staff? b) Degree of bullying behaviour experienced and length of service of medical staff? Method Research Design The present investigation is a descriptive-correlational research that intends to define the present levels of bullying occurring within the NHS. The study is descriptive because it aims to depict the levels of bullying, the degree of awareness and involvement of nursing staff and hospital personnel in the drafting an deployment of bullying policies.

In effect, there will be a need to compute for means, standard deviations, frequencies, and percentages to present the descriptive outcomes. The research is also categorised as correlatinal since it will also establish relationships between a) bullying behaviour and level of efficacy of the NHS Anti-bullying policy, b) degree of bullying behaviour experienced and age of the medical staff; and c) degree of bullying behaviour experienced and length of service of medical staff. Samples and Sampling Plan All hospitals within the NHS umbrella are qualified to take part in the investigation.

Each of these hospitals shall be invited to take part in the study. They shall be selected through the use of a random numbers table. A total of 100 nurses and hospital staff shall be chosen through stratified random sampling, where the number of respondents shall be based on the relative size of the hospital (compared to the other hospitals chosen). A consent form has been distributed to the respondents of the study which explained that they are to willingly participate in the study and that they could choose to cease from participating at any time, without reprisal.

They were also assured of the confidentiality of their responses and of their anonymity. All these measures have been undertaken for ethical reasons (Bryman, 1992). For the structured interview, 10 out of the 100 nurses / midwives / health care assistants and student nurses who originally took part in the study shall be asked questions that relate to their bullying experiences. This small sample shall be purposively chosen such that half of them have reported the bullying behaviour while the remainder did not.

Moreover, selected key managers of the trust shall also be interviewed on how bullying is curbed within their respective areas of jurisdiction through the Trust’s anti-bullying policy. The qualitative data that will be gathered from the interviews shall supplement the quantitative findings from the survey questionnaire (Bryman, 1992). Instrument The NHS nursing staff and medical personnel have been asked to accomplish a self-constructed bullying questionnaire, whose items were based from the NHS Trust anti-bullying policy. The instrument uses a 5-point Likert type scale, which each number representing an opinion.

The tool has three major parts. The first potion requests for demographic information, including gender, age, and tenure. The second portion is further subdivided into two parts: bullying experiences and the efficacy of the NHS Trust anti-bullying policy. The first sub-item intends to measure the degree of bullying experienced by the respondent and by others who also belong to that workplace. The items on efficacy talk about about individual and managerial responsibilities as regards curbing bullying behaviours in the workplace, conduct of investigations, and bullying awareness and training.

Finally, there is an item which requests for an overall evaluation of the policy’s efficacy. Procedure The instrument shall be finalised and pilot tested. Undertaking a pilot study is necessary for instrument develepment. Chisnall (1997) points out that the value of a pilot study lies in validating the accuracy and consistency of “sampling frames” and planning the final sample size by measuring variability. According to Hunt et al (1982), “pilot testing pertains to testing the questionnaire on a small sample of respondents to identify and eliminate potential problems.

” The pilot test will entail the participation of 5 respondents from any of the NHS hospitals chosen. Invitation letters shall be sent to all hospital administrators of the NHS, soliciting permission for the conduct of the study. Once permission is granted, the respondents shall each be given a consent form and shall be requested to return it three days later. On the agreed upon date, the researcher shall visit each of the randomly chosen hospitals to administer survey forms to the respondents.

The survey questionnaire will be personally administered by the researcher to be able to address inconsistencies in addressing respondent queries (Oppenheim, 1992). On completion of the nursing staff, medical personnel and administrators of the NHS will be thanked, and shall be briefed on the study’s objectives. The outcomes shall be made available to them upon completion of the study. On the whole, the researcher expects that the level of bullying will be correlated with the perceived efficacy of the policy. Those who are older in terms of age and with longer tenures will tend to have lesser degrees of bullying experienced.

Method of Data Analysis Pearson’s correlation coefficient shall be used as the main technique for data analysis apart from the descriptive statistics – the mean, standard deviation, frequencies, and percentages. Pearson r is a measure of the degree of association between two measures. When the figure is positive, this indicates that as one measure increases, there is a corresponding increase in the other. Salkind (2000) asserts that the Pearson’s correlation coefficient necessitates that both variables are measured on the interval scale.

The present study shall make use of the Pearson correlation coefficient to present the relationships among the variables degree of bullying, efficacy of bullying policy, age, and tenure of respondent. References Bryman, A. (1992). Reasearch methods and organisation studies. London: Routledge. Chisnall, P. M. (1997). Marketing research (5th ed. ) Berkshire: McGraw-Hill. Cox, E. (2005). Bullying is tricky for employers. The Journal, 32. Einarsen, S. & Skogstad, A. (1996). Bullying at work: Epidemiological findings in public and private organizations.

European Journal of Work and Organizational Psychology, 5, 185-201. Glendinning, P. (2001). Workplace bullying: Curing the cancer of the American Workplace. Public Personnel Management, 30(3), 269-275. Guynn, J. (1998). Mean business: Workplace bullies undermine morale and productivity. Providence Sunday Journal (11/01/98).. Hunt, S. D. , Sparkman, J. R. D. & Wilkox, J. (1982). The pretest in survey research: issues and preliminary findings. Journal of Marketing Research. May, 269-273. NHS Anti-bullying policy. (2002). Retreived on November 28, 2006 from http://www. southtees. nhs.

uk/foi/HRPantibullying. pdf O’Hare, P. (2006). 5, 000 nurses attacked. The Mirror, 6. Olweus, D. (1999). Norway. In P. K. Smith, Y. Morita, J. Junger-Tas, D. Olweus, R. Catalano, & P. Slee (eds. ) The nature of school bullying: A cross national perspective. London: Routledge. Oppenheim, A. N. (1992). Questionnaire design interviewing and attitude measurement. London: Pinter. Pearson, C. , Anderssen, L. & Portah, C. (1999). Assessing and attacking workplace incivility. Academy of Management Review. Salkind, N. J. (2000). Statistics for people who hate statistics. USA: Sage Publications Inc.

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