Former BGH doctor launches scathing attack on NHS Borders management

Dr Andrew Docherty worked at Borders General Hospital for 15 years as an associate speciality doctor in general medicine and cardiology from the late 1990s to 2012 and has spent a total of 40 years working in the NHS.

Now semi-retired, he has spoken out after speaking to increasingly worried ex-colleagues – doctors, nurses, porters, kitchen workers – who are dismayed at the low staffing levels at the hospital, poor morale, pay discrepancies between management and front-line workers and heavy workloads leading to mental health issues and absenteeism.

He says there is a sense of “hopelessness” amongst under-pressure staff and is speaking out to give them a voice.

Dr Docherty, who has emphasised that the failings he is highlighting pre-date the Covid-19 pandemic, is now calling on current and ex-employees who have similar concerns to contact him to help form a new independent body to scrutinise the actions of NHS Borders.

The chief executive of NHS Borders Ralph Roberts has responded to the criticisms by issuing a full statement.

Mr Roberts says he recognises the comments made in regard to the pressures staff are under, which he says senior staff are addressing, saying “it’s a place none of us want to be in terms of the pressure the health service is under and the pressure on our staff. I absolutely get that and think it’s a very legitimate conversation to be having.”

He goes on to outline an ongoing drive to bolster recruitment and highlights the regular contact senior management has with Scottish Government ministers to address staff shortages and other issues, while also thanking NHS Borders staff for their “ongoing commitment and dedication” throughout testing times.

Dr Docherty, who now runs a medical advocacy for people having difficulty navigating the NHS, said: “Ex-colleagues have been expressing to me a sense of hopelessness about whether they can do anything to improve their working conditions. They are being asked to do too much and to cover very often for absence and sick colleagues and to be subject to domination by management to achieve corporate objectives.

“Everybody is saying there is a fear of management, a fear that if you criticise management or don’t meet their objectives your career progression will be impacted. This is the feedback I am getting from ex-colleagues still within the hospital.

“Increasingly over the last two or three years there have been a number of experienced nursing staff retiring early because they can’t take the pressure any longer of what they see as a combination of under-staffing and pressure from management.

“Generally people approach me about low staffing levels in the wards. The most recent example of that was an auxiliary nurse who tells me that on night duty in a busy 30-bedded geriatric ward there were only three staff available and only two of them were trained, one was a care assistant. That is by far and away inadequate care.

“Whether the Trust says they are adhering to benchmark standards it’s the view of myself and my ex-senior colleagues in both the nursing and medical profession that this is completely inadequate and will result in significant suffering and premature deaths in some cases in such under-staffed wards.

“The management will acknowledge they have a problem with recruitment, but it is important for us to say to them that if they cannot adequately staff their wards then it is incumbent on them to speak to politicians about it, to stand up and be counted, rather than to bury it and say ‘that’s the way it is’.”

Dr Docherty, who lives in Melrose, added: “One of the other major issues, and a point of great resentment within the workforce, and we have been approached by many people about this, is pay differentials. There is a perception that front-line medical staff – including nurses and care assistants – are paid derisory levels compared to the corporate, inflated salaries at the top of the management tree.

“One of the previous corporate directors of NHS Borders, I obtained his salary via the Freedom of Information Act, and he was being paid £220,000 per annum for doing nothing that impacted directly on suffering and patient care.

“I have the salaries of all the NHS directors and their expenses that show the difference in lifestyle between a corporate NHS management person and somebody delivering primary nursing care and medical care at the front-line. We strongly suspect this is the case throughout Scotland, but we’re not talking about the rest of Scotland, we are trying to deal with our own local problems.”

Dr Docherty also raised concerns over primary care standards in the region, labelling it “third-rate medicine”.

He said: “There is also a great deal of outrage within the Scottish Borders at inadequate levels of primary care in general practice engagement. There are many people who are very resistant to the idea of telephone consultation.

“Patients who are concerned about rashes and physical complaints are often asked to send photographs of it to GPs. This is third-rate medicine and will lead to errors and sometimes, potentially, fatalities.

“What that results in is many more people going to the Borders General Hospital because they can’t get an appointment with their GP.

“The main issues at the Borders General Hospital are low staff morale, poor staff mental health, perceived lack of status among front-line workers, both financially and in terms of workload, and dangerous levels of under-staffing.

“What I am interested in is trying to galvanise public opinion to form an independent body to scrutinise the management of the Borders General Hospital. It would be an independent local public body for the NHS Borders to be accountable to groups of local people, because it appears we cannot trust the health board to adequately manage the NHS Borders.

“What I would like to encourage is for any ex-employees and current employees who wish to join with myself in forming a group, a ‘watchdog’ about staffing levels and staff morale at the GBH, to get in touch.”

He added: “It has to be emphasised that people have come and told me this repeatedly and they have asked me to speak on their behalf because they don’t feel empowered to do so because any time they have tried in the past they have usually been sidelined or basically ignored by different levels of management.

“They are feeling undermined and under-valued compared to the higher echelons of management. A good example of that is that a number of senior managers are still working from home post-Covid, while the average porter and the average nurse turn up for 12 hour shifts in under-staffed wards, putting themselves at tremendous psychological pressure, leading to ill-health and absenteeism. The people who save lives and relieve suffering have to turn up and meet the service users face-to-face.”

In response to Dr Docherty’s assertions, NHS Borders chief executive Mr Roberts has issued the following statement, which is published in full.

“I am keen to directly address the claims made by Dr Docherty focusing on staffing levels and staff morale, pay, and scrutiny of my board executive team and the wider board.

“NHS Borders continues to face unprecedented levels of demand following the pandemic. This demand, and the consequences of it in terms of flow through our health and social care system, is placing exceptional pressure on our workforce. The pressure is not limited to the impact on day-to-day working, and is exacerbated by a shrinking workforce due to retirement, national shortages of trained nurses and other healthcare professionals, and the consequences of the pandemic on staff health and well-being.

“I recognise the comments made about staffing levels and the pressures on staff which are consistent with what staff are telling us directly. Senior management teams, in partnership with our staff side colleagues, are continually reviewing what else can be done to improve staffing levels and relieve pressure on staff. This includes a focus on recruitment of healthcare support workers and other support staff to work alongside our trained (registered) nurses to support patient care, and development of a Borders-wide marketing campaign to attract registered nurses from across the UK and overseas to come and work for NHS Borders.

“We place great importance on staff well-being and have continually acknowledged the pressure that staff are facing. We work together with staff representatives and our HR and occupational health teams to identify whether there is more we can do to support our existing staff in order to improve staff retention and morale.

“Recognising the challenges currently faced by our staff, we are in regular contact with the Scottish Government on these issues with weekly opportunities for directors to talk to our colleagues in Government. In the past few months we have hosted a series of visits to a variety of our sites across NHS Borders, including the Borders General Hospital, from the cabinet secretary for Health & Social Care as well as the Government’s clinical director, director general for Health & Care and most recently, Wednesday, August 17, the chief nursing officer.

“During these visits we encouraged staff to be open and honest with our visitors, and have made sure that there have been opportunities to listen to staff directly and hear about their experiences. My executive and senior management teams have also been direct in describing the current challenges we face, along with opportunities that have arisen and been acted upon, and examples of success achieved.

“In relation to the issues raised about pay, staff in NHS Borders are paid in line with Scottish NHS pay rates that are ultimately agreed between the unions and the Scottish Government. In recent years this has included pay deals with a focus on addressing low pay. NHS Borders welcomes this work and will continue to apply to all pay deals that have been agreed.

“Given the ongoing discussions around the current pay offer it would be inappropriate for me to comment any further on this while discussions progress between the unions and Scottish Government. That said I do recognise the significant challenges our staff, and particularly those on lower pay scales face, with the current cost of living crisis.

“With respect to the pay differential between staff on different pay scales, NHS Borders pays staff according to national pay scales and publishes all salaries associated with senior staff, as well as pay differential for staff in line with requirements for reporting of public bodies.

“NHS Borders is fully aware of the requirement to be accountable to our local population. However it is important that this accountability is carried out in a way that is appropriate and reflects the voices of our whole community or their responsibilities, rather than self-appointed individuals.

“I meet quarterly with local elected representatives (MPs/MSPs) and hold meetings with local councillors on specific topics as they arise. There are numerous ways in which the public can get in touch with us, including via the Care Opinion platform, via our Patient Feedback team and by raising issues and concerns via local councillors and MPs/MSPs. In addition, NHS Borders, as a part of Scottish NHS, is directly accountable to Scottish Ministers. This accountability is delivered through regular reporting and scrutiny as well as a formal annual review process led by the Cabinet Secretary.

“I would like to publicly thank NHS Borders staff, once again, for their ongoing commitment and dedication to providing the best possible care to the people of the Borders during the most difficult of times.”

If you share Dr Docherty’s concerns and wish to support his efforts to form an local independent scrutiny body he can be contacted at molendinar1000@gmail.com

Any current and former staff or service users wishing to share concerns or raise issues around healthcare can contact paul.kelly1@jpimedia.co.uk