Safety Equity Senior Research Fellow, Dr Olivia Joseph, from the NIHR Yorkshire and Humber Patient Safety Research Collaboration at Bradford Institute of Health Research, is involved in a new programme aimed at tackling NHS bullying, harassment and abuse. A new 16-month programme to reduce bullying, harassment and abuse of NHS staff, with a focus on closing long-standing ethnicity gaps, has been announced by the NHS Race and Health Observatory.
The National Institute of Health and Care Research (NIHR) Yorkshire and Humber Patient Safety Research Collaboration is working together with the NIHR Midlands Patient Safety Research Collaboration and the University of Sheffield to deliver the initiative. Using a mixed-methods approach, the programme will analyse NHS Staff Survey data and produce evidence-based recommendations and resources designed to support NHS Trusts, Integrated Care Boards (ICBs) and regions to create safer, more inclusive workplaces.
Despite ongoing efforts, Black, Asian and minority ethnic staff continue to face disproportionately high levels of bullying and harassment. They represent almost 30% of the NHS workforce, yet the 2023/24 NHS Workforce Race Equality Standard reported that 82% of NHS hospital trusts recorded higher rates of reported bullying, harassment or abuse (BHA) among minoritised ethnic staff compared with white colleagues. These experiences have been linked to poorer wellbeing, increased sickness absence, higher turnover and risks to patient safety.
To address these persistent inequities, the programme will provide detailed data on bullying and harassment trends at regional, ICB and trust level, segmented by ethnic group. It will draw on historical staff survey data (2021 – 2024), identify trusts that have successfully reduced BHA, and explore minoritised ethnic staff experiences and organisational factors that underpin their progress. The work will also highlight evidence-based strategies that NHS organisations can adopt to support all staff and reduce incidents of bullying, harassment, and abuse. This builds on Dr. Olivia Joseph’s research into organisational influences on racialised incivility in English maternity services. She found that concerns were heard but often minimised, deflected or not acted on, compromising psychological safety and weakening teams’ ability to anticipate and prevent risk. The work shows how incivility impacts patient safety through relationships, whose voices are valued, and whether concerns receive meaningful follow-up.
Dr Joseph stressed the importance of the programme for patient safety as well as staff wellbeing. “When staff are ignored, undermined or spoken to with disrespect, it chips away at trust, communication and teamwork which are the very foundations of safe
care. Using a reflective, evidence-based approach allows us to evaluate which actions genuinely make a difference for racially minoritised staff and supports NHS teams to respond effectively.”
Dr. Justin Aunger, Research Fellow and Project Lead, NIHR Midlands Patient Safety Research Collaboration; Dr. Jane Ferguson; and Dr. Ashok Patnaik at the University of Birmingham, said:
“Our previous research on bullying, harassment, and abuse has highlighted the persistent, unacceptable gap in experiences for ethnic minority staff and the urgent need to understand and address it. We are delighted to work with the Race and Health Observatory, and our colleagues at the University of Sheffield and the NIHR Yorkshire Patient Safety Research Collaboration, on this important project.
“Using a mixed-methods approach, we will analyse NHS staff survey data to uncover contributing factors and set achievable targets for NHS Trusts. We will also amplify staff voices from Trusts across the country that are often marginalised (or unheard), to identify what truly makes a difference on the ground. As the NHS workforce becomes ever more diverse, ensuring all staff feel valued and supported is essential for staff wellbeing and patient safety.”
Professor Rebecca Lawton, Director of the Yorkshire and Humber Patient Safety Research Collaboration and the NIHR SafetyNet, emphasised that the network of six NIHR Patient Safety Research Collaborations (SafetyNet) is committed to reducing safety inequalities. She said “This can only happen if those people who care for patients are treated with respect and feel emotionally and physically safe in their teams and workplaces. We must better understand, through research, those strategies that help organisations to tackle abuse, particularly when exposure to these behaviours is more frequent for some people (racially minoritised staff) than others.
Leaders from the NHS Race and Health Observatory echoed the need for consistent, zero-tolerance approaches to discriminatory behaviour, noting that the impact extends beyond individuals to patient safety, organisational culture, and the financial sustainability of the NHS.
Insights from this programme will lead to recommendations and improvement targets for NHS organisations, helping create a more inclusive, supportive and equitable working environment. The work contributes to the Observatory’s broader “Fairer Futures” programme to tackle race inequalities across the NHS workforce and supports the ambitions of the NHS’s new 10-Year Health Plan.
