Press Releases Saturday 23 January 1999
No 7178 Volume 318
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
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If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) BULLYING IS A SEROUS PROBLEM IN NHS
(2) LOWERING
OF UNREALISTIC PUBLIC EXPECTATIONS IS ONLY
WAY TO SAVE NHS
(3) ETHICAL GUIDELINES FOR ALL WHO WORK IN HEALTH CARE
(1) BULLYING IS A SEROUS PROBLEM IN NHS
(Workplace bullying in NHS community
trust: staff questionnaire survey)
http://www.bmj.com/cgi/content/full/318/7178/228
Bullying is a serious problem in the NHS
experienced by more than one in
three staff, says Lyn Quine from the University
of Kent at Canterbury in
this week�s BMJ.
In a survey of 1100 employees working for
an NHS community trust in south
east England, the author found that 38
per cent of employees reported
experiencing one or more types of bullying
in the previous year. 42 per
cent of employees had witnessed the bullying
of others. Quine found that
when bullying occurred it was more than
likely to be by a manager and even
though two thirds of victims tried to
take action, they were dissatisfied
with the outcome.
The authors says that staff who have been
bullied have lower levels of job
satisfaction and higher levels of job
induced stress, depression, anxiety
and intention to leave. However,
she also says that support at work can
help to protect victims from some of the
damaging effects of bullying and
therefore calls upon employers to implement
policies and procedures that
comprehensively address the issue.
Contact:
Lyn Quine,
Reader in Health Psychology,
Centre for Research in Heath Behaviour,
Department of Psychology,
University of Kent at Canterbury,
Canterbury
email: L.Quine{at}ukc.ac.uk
(2) LOWERING OF UNREALISTIC
PUBLIC EXPECTATIONS IS ONLY
WAY
TO SAVE NHS
(The NHS: possibilities for the endgame.
Think more about reducing
expectation)
http://www.bmj.com/cgi/content/full/318/7178/209
The demise of the NHS may lie in the mismatch
between what is expected by
patients and what can be provided by the
health service, says Dr Richard
Smith in an editorial in this week�s BMJ.
As well as improving the
provision of our health care, Smith suggests
that �...it would also seem
sensible to work on expectations: death
is inevitable; most major diseases
cannot be cured; antibiotics are no use
for the flu; artificial hips wear out;
hospitals are dangerous places; drugs
all have side effects�.
Speculating on the future of the NHS, amid
�...the current media frenzy
over the latest NHS crisis...� Dr
Smith fears for the staff who suffer
from the fallout of the mismatch between
expectation and provision. �They
are caught like hamsters in a wheel that
must go faster and faster�, he
says and rather than being compensated
for their poor pay by the feeling
that they are doing an important job well,
they are now dogged by a feeling
of failure - �They now have low pay and
disappointment.� As a consequence,
nurses and mangers are leaving the sector,
while doctors contemplate
providing their services outside the NHS.
Dr Smith concludes that the �best health
system in the world� is not one
which provides �...everything for everybody...�
but one that �..determines
what society wants to spend on health
care and then provides explicitly
limited, evidence based services in a
humane and open way without asking
the impossible of its staff.�
Contact:
Dr Richard Smith,
Editor, BMJ Tavistock Square,
London
email: rsmith{at}bmj.com
(3) ETHICAL GUIDELINES FOR ALL WHO WORK IN HEALTH CARE
(Share ethical principles for everybody
in health care: a working draft
from the Tavistock Group)
http://www.bmj.com/cgi/content/full/318/7178/248
In this week�s BMJ, the Tavistock Group
- comprising physicians, nurses,
health care executives, academics, ethicists,
a jurist an economist and a
philosopher from four nations (the US,
the UK, Mexico and South Africa) -
presents its latest draft of a set of
comprehensive ethical principles to
guide all those working in health care
and to engender a sense of
togetherness and co-operation within health
care systems.
Simultaneously published in the Annals
of Internal Medicine (1999;
130:143-7) and the Nursing Standard (1999;13(19):33-7)
the guidelines aim
to address the ethical problems inherent
within complex health care
systems, which are serviced by teams of
professionals and their ever
sophisticated technology (as opposed to
the scenario 150 years ago when
individual practitioners worked autonomously,
visiting patients in their
homes). These professionals work
in an environment of increasing demands
on their resources; financial pressures;
limited resources and inadequate
health care delivery systems which inevitably
serve to create ethical
tensions.
The Tavistock Group details five major
principles which it believes should
govern health care systems, the first
of which underlines that health care
is a fundamental human right. The
second principle states that even though
the care of individuals is at the centre
of health care delivery, this must
be viewed and practiced within the overall
context of continuing work to
generate the greatest possible health
gains for groups and populations.
Thirdly, the Group suggests that
health care systems are responsible for
preventing illness and alleviating disability
and fourthly that
co-operation between all those working
within health care systems is
imperative, both for the individual patient
and for the population as a
whole. Finally, the authors cite
the improvement of quality as being at
the heart of all health care systems.
The Tavistock Group elaborates on each
of these principles and emphasises
that they have been drafted by way of
a discussion document, it welcoming
contribution from readers in all nations
and all disciplines, in order to
work towards a formalised set of shared
ethical guidelines.
Contact:
Dr Donald Berwick,
President, Institute for Health care Improvement,
Boston, US
email: dberwick{at}ihi.org
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact Jill Shepherd;pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)
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