Internal ‘chutes’ and legal ‘ladders’: negative behaviour anomalies in the NHS

Abstract

Safeguarding workers from negative behaviours remains an ongoing concern for health sector organisations globally, and in the UK’s National Health Service (NHS). Although the term ‘negative behaviour’ includes acts ranging from bullying and physical violence to banter and rumours, only harassment has a legal definition in UK law. As a result, individual Trusts within the NHS have had to create their own internal policy frameworks in order to identify, address and redress a wide range of negative behaviours without legal definition. In our study of three NHS Trusts, we frame such NHS policy responses as ‘chutes’, or policies seeking to de escalate the manifested negative behaviour, deal with conflict informally and restore business as usual. We contrast such ‘chutes’ with policy ‘ladders’, manifest in the instance of severe harassment cases (which we term ‘anomalies’), where legal obligations supersede organisational policy and escalate the matter in line with the appropriate legal provision. We find that organisational ladders are less effective than chutes across our sample with all three NHS Trusts recording lower incidence of anomalies than those reported by their employees.