NSFT deputy chief Cath Byford hits out at ‘clown culture’

7:00 AM September 23, 2022

The deputy chief of the region’s failing mental health trust has hit out at a “clown culture” in the organization which has thwarted efforts to improve its fortunes.

Cath Byford used the term to describe the working environment she had encountered at the region’s mental health trust – which is currently in special measures – since she joined in May.

She identified a number of internal issues which she said had driven staff away and were hampering attempts to improve the organization’s performance.

Mrs Byford made the outspoken comments at a meeting of the Norfolk and Suffolk NHS Foundation Trust’s board of directors on Thursday.

She said that many workers had left, feeling they could not progress within the organization unless they were part of an “in crowd”.

She added that “micro cultures” had taken root, whereby some staff felt excluded or left out of cliques.

“There is a perception and a reality that people have been ‘given’ jobs which is seen as divisive and unfair,” she said.

“This is the reason people are leaving as they feel as though they are not given fair or equal opportunity to progress.

“We need to make sure that we lose the clown culture where people feel they are either in or out – this is a big part of our problems.”

The comments came during a debate about how to improve staff morale and retention, which are vital to the standard of mental health care that the trust provides for patients.

They come just weeks after a leaked letter from 140 of the trust’s own doctors saying they “lacked confidence” in the organization’s leadership.

The trust was rated as inadequate by the Care Quality Commission (CQC) in April, with the regulator highlighting scores of concerns around the safety of its services.

During the inspection, an extensive list of 108 actions were identified for the trust to address – described as “must dos”.

A report which went before the board revealed that thus far, 87pc of these had been acted on.

It was confirmed during the meeting that the trust was being taken to task over these this month, with CQC inspectors currently assessing the progress that has been made.

Zoe Billingham, the trust chairwoman, told the meeting that inspectors from the CQC would be visiting wards throughout September, with some of these assessments already having been carried out.

Stuart Richardson, NSFT’s chief executive, added: “We know we still have significant improvements that we need to make but we welcome the opportunity to show our colleagues in the CQC the progress we have made.”

Stuart Richardson, chief executive of NSFT
– Credit: NSFT


A report presented at the meeting acknowledged there were “deep pockets” of discrimination within the trust.

It highlighted that black and minority ethnic workers (BAME) were more likely to be dismissed during disciplinaries and were subject to abuse from colleagues and patients.

Mr Richardson said the trust would take a “zero tolerance” approach to any form of discrimination – but admitted there were no quick fixes.

He said: “This does not mean we are labeling people as racist, homophobic, transphobic or anything like that. We do not expect people to be publicly shaming.

“However, this is a key piece of work for us and we have to make sure there a zero tolerance approach to any form of discrimination.

“We are really determined that it needs to stop and get right to the heart of this longstanding issue.

“Inaction is not an option.”

The report identified that BAME employees at the trust appear to be 27pc more likely to be dismissed from their jobs than white workers.

Since April 2021, three BAME employees have been dismissed from the trust, while five non-BAME staff members suffered the same fate.

However, just seven BAME workers faced disciplinary, compared with 31 non-BAME – mean the proportion of sackings is 27pc higher.

Mrs Byford added: “We want every person working at the trust to feel safe, appreciated, respected and supported.”

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