The news that a "toxic row" between surgeons at the cardiac unit in a London hospital has apparently contributed to a near doubling of patient mortality is alarming, but unsurprising.
Having worked as a mediator on NHS disputes for many years, I know that the sector has made great strides with the use of mediation for resolving patient claims; and CEDR is proud to be at the forefront of this endeavour, working alongside sympathetic lawyers and NHS Resolution (whose very name signals a change from its former life as the NHS Litigation Authority). Financial disputes between commissioners and providers now also regularly go to mediation.
There is, however, much more to be done internally within the NHS. Just like any employer - and let's remember that the NHS is the 5th largest employer in world - it has its fair share of workplace conflict. Furthermore, much of the work is highly pressurised, and for high stakes, and perhaps we're all a little guilty of accepting that, as long as the surgeon saves our life, having a decent bedside manner is an optional extra.
Much of the health sector has now adopted Dr Atul Gawande's thinking about the need for checklists in the operating theatre, taking lessons from the aviation industry which learned the hard way that the combination of autocratic airline captains and co-pilots afraid to speak up is a disaster waiting to happen.
But it seems that there's still a long way to go if the health sector is to address inter-professional conflict of the sort found at St George's. Fortunately a remedy is on hand in the form of effective conflict management training and systems, backed up by readily accessible mediation processes where necessary.
Sounds like it's time to bring in the conflict consultants.
Reference: The Checklist Manifesto: How to Get Things Right, Atul Gawande (2009)
Graham Massie is a director, consultant and mediator with the Centre for Effective Dispute Resolution (CEDR). To find out how our conflict management specialists can help your organisation cut the cost of conflict, contact our team at firstname.lastname@example.org or call 020 7536 6000.
...the surgeons were split into "two camps" exhibiting "tribal-like activity". Professor Berwick said: "Some felt that there was a persistent toxic atmosphere and stated that there was a 'dark force' in the unit. "In our view the whole team shares responsibility for the failure to significantly improve professional relationships and to a degree surgical mortality." He added: "The surgical team is viewed as dysfunctional both internally and externally."