Promoting partnership working in the NHS

Creating a culture of civility, compassion & respect

The SPF’s collective call to action encourages employers and trade unions to work in partnership to create cultures of civility, compassion and respect in NHS workplaces. To support this work, the SPF is signposting relevant information, tools and resources. 

There is still much to do to improve workplace cultures. In the 2019 NHS Staff Survey, 12.3 per cent of staff who responded had experienced at least one incident of bullying, harassment or abuse in the last 12 months from managers and 19 per cent had experienced at least one incident of bullying, harassment or abuse in the last 12 months from other colleagues.

See our latest news web page to find out what's happening across the system to build positive workplace cultures.


  • Website includes a policy discussion paper that describes what bullying and ill treatment looks like and the likely causes and impact of bullying on an individual and organisation.
  • Website also contains a bullying and harassment at work advice leaflet guide for employees and a guide for managers and employers.
  • Free online courses in bullying and harassment, conflict resolution, managing people and performance management.

British Medical Association (BMA) 

Chartered Institute of Personnel and Development 

Civility saves lives website reveals the impact of rudeness on the recipient, staff on-looking and patients and their relatives.

NHS Employers 

NHS England & NHS Improvement Creating a culture of compassionate and inclusive leadership  

NHS Staff Council's Health, Safety and Wellbeing Partnership Group has produced an infographic to raise awareness of the impact of bullying and what organisations, managers, and individuals can do to tackle it.

Royal College of Nursing - Bullying and harassment 

Royal College of Obstetricians and Gynaecologists and Royal College of Midwives - Undermining toolkit 

Royal College of Surgeons of Edinburgh anti-bullying campaign #LetsRemoveIt

StonewallBullying – preventing the bullying and harassment of gay employee

TUC - Bullying and harassment - practical guide for reps 

UNISON - Bullying and harassment in the workplace

In 2019, partners agreed to extend the focus of the SPF's call to action to include tackling sexual harassment in the NHS.

Definition of sexual harassment

Sexual harassment is a legal term, defined in the Equality Act 2010 as unwanted conduct of a sexual nature, which has the purpose or effect of violating an individual’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that individual.

Sexual harassment in the NHS

There is limited information on the level of sexual harassment in the NHS. It’s Never OK: a report on sexual harassment against healthcare staff, published by UNISON in June 2019, found eight per cent of respondents said they had been sexually harassed in the last year. The report also gives information on the types of sexual harassment, the perpetrators and level of reporting and concludes by requesting employers and the government be more proactive in tackling sexual harassment.

In response to the survey results, Sara Gorton, SPF trade union chair said:

“These findings show why the SPF focus on creating safe and compassionate workplaces is so important to recruiting and retaining staff. Making sure staff are safe and treated with respect is a crucial part of partnership working and would urge local partnerships to look at the findings of the survey and consider how they can use the SPF's call to action to start a constructive and honest conversation about addressing sexual harassment in the workplace.”

Danny Mortimer, SPF employer chair, said:

“NHS organisations have clear policies in place to deal with reports of harassment or bullying. It is not always easy for concerns to be raised – especially when the perpetrators are in positions of authority or patients, but it is important staff report incidents. Most NHS organisations have specially trained staff in place to help colleagues raise concerns about such utterly abhorrent behaviour. Freedom to speak up guardians as well as Guardians of Safe Working, chaplaincy, trade union and HR staff are also on hand to offer support.”

Sexual harassment in the workplace

Lifting the lid on sexual harassment and power in the workplace, a conference paper produced by Dr Virginia Fisher and Dr Sue Kinsey, University of Plymouth for the CIPD Applied Research Conference 2018 identifies ways to prevent sexual harassment, including: 

  • organisations being clear on what is meant by sexual harassment
  • an organisation’s policy on sexual harassment should be easily accessible to current and potential employees
  • training should be used to help the policy be effective
  • managers should receive conflict management training with a focus on emotional skills – enabling them to effectively support victims
  • there needs to be anonymous reporting channels in an organisation and for management to take reported sexual harassment seriously and respond in a timely manner
  • organisational culture, especially where there is gender inequality between men in senior and women in less senior grades, can result in higher levels of sexual harassment. Where this is the case, employers should acknowledge and seek to address this imbalance.

To read the research paper in full, see the CIPD website.

Sexual harassment at work – free legal advice for women.

RIGHTS of WOMEN is a women's charity that provides free legal advice for women in the UK who are experiencing sexual harassment in the workplace. Have a look on their website for more information and advice on the support available. 

See below examples of successful partnership working to create positive workplace cultures:

  • The Christie NHS Foundation Trust went from negative to positive by developing an informal approach to addressing conflict and promoting positive working environments and relationships.
  • Mersey Care is creating a just and learning culture by asking what happened, instead of who is responsible, following errors. This is facilitating learning and improvement in patient and staff care and experience and improving staff morale through the reduction in formal HR interventions, such as disciplinaries.
  • North Staffordshire Combined Healthcare NHS Trust, UNISON North Staffs Community Health Branch and RCN North Staffordshire Branch worked to embed a culture of diversity and inclusion, by promoting awareness and accelerating positive change to improve the experience of staff, especially those in minority groups.

There are further examples of initiatives to improve workplace cultures in NHS organisations set out in practice posters from 2017, updated in 2018.

The SPF creating positive cultures summit brought together NHS employers, Arms Length Bodies and trade unions to reflect on the first year of the call to action, and set priorities for the year ahead. For further information, please see the summit notes

Mandy Williams, Inspection Manager, Care Quality Commission (CQC), discussed the tackling bullying call to action and how it can link to the well-led domain. Download the CQC slides.

Organisations at the summit were asked to complete a poster to share their tackling bullying projects and initiatives. The posters were displayed at the summit, and show the excellent progress being made to create positive workplace cultures within the NHS. Download our template and share your tackling bullying projects by emailing

Some of the organisations at the summit have completed a follow up poster charting progress made over the year. These posters have been collated and provide useful information that can be used by others who want to replicate or learn from existing practice.

SPF colleagues attended a follow up meeting to further discuss the year two priorities. Take a look at the slides from this meeting.



The SPF's tackling bullying in the NHS: a collective call to action, was signed in December 2016 by Danny Mortimer, Chief Executive, NHS Employers and former Minister of State for Health, Philip Dunne, and Christina McAnea, former Head of Health at UNISON. 

The call to action invites all NHS organisations to:

  • achieve the overarching leadership and cultural change to tackle bullying
  • support staff to respectfully challenge problem behaviours
  • publish their plans and progress so staff, patients and the public can hold them to account.

The SPF Workforce Issues Group (WIG) is leading the SPF’s work on the call to action drawing together evidence and front-line experiences to make a strong case for change.  

In 2018/19 the WIG led webinars on:

  • the role of line management in tackling bullying
  • raising awareness of the impact of bullying on patient experience 
  • connecting the work going on across the NHS to support positive workplace cultures.

For a summary of each of these webinar discussions and a copy of the presentations used, see the following web page.

In July 2019, the SPF published a progress report on Creating positive workplace cultures and tackling bullying in the NHS: a collective call to action, which included priorities for year three. These priorities include Creating a culture of civility compassion and respect in the NHS (the new name for the initiative) to have a wider focus, which includes tackling violence and sexual harassment against staff and encouraging action to support disabled, BME and LGBT staff, who tend to have a worse experience at work and suffer higher rates of bullying, harassment and abuse.


Views on building positive workforce cultures

NHS Employers blog on pay progression, disciplinaries and the potential disproportionate impact on black and minority ethnic (BME) staff 

In an NHS Employers blog staff-side and management side co-chairs of the Equality, Diversity and Inclusion Group (part of the NHS Staff Council) share insights on the importance of partnership working to ensure that the new pay progression system is implemented equitably. The blog highlights guidance which includes recommendations on how to close the ethnicity gap in rates of disciplinary action across the NHS workforce. Working in partnership, the group considers risks and how to ensure staff are not unfairly held back from progressing. You can read the blog here.

Henrietta Hughes, NHS national guardian, in an interview with Healthcare Manager highlighted a link between staff being able to speak up and an organisation's CQC rating. She says, in trusts rated outstanding, managers are far more likely to encourage staff to speak up than in trusts rated inadequate. 

In his blog, rethinking disciplinary action in the NHS, Roger Kline looks at the cost of unnecessary disciplinary investigations, and considers how a different approach could not only save the NHS millions of pounds each year, but most importantly would benefit patient care and safety.

Jim Mackey, former chief executive of NHS Improvement, spoke at Confed17 on the importance of talking openly about bullying, and the need for individuals to call it out if, in their interactions with the NHS regulators, they feel they are being bullied.