Workforce, training and education
East of England

Bullying, Undermining and Harassment Guidance

This guidance is applicable to all medical, dental and pharmacy trainees managed by East of England.

1. Introduction

Problems with bullying, undermining and harassment are unfortunately common within the NHS. They can relate to individuals or organizational culture, or to both, and are often accompanied by a fear of reporting the behavior (whistle blowing).  Precipitants may include heavy workloads, staff shortages and external pressures such as performance targets, although these are not excuses for any bullying or harassment.

East of England views bullying and harassment as completely unacceptable, and is committed to ensuring that workplace environments used for training are suitable for the purpose, being free from bullying or intimidating behavior.

Your employing organization carries legal responsibility for bullying and harassment issues.This document should always be read in conjunction with local policies.

If you are not sure who your employer is, then check your payslip.

2. Definition of bullying and harassment

Often these terms are regarded as interchangeable and for some bullying is a form of harassment.

Bullying is defined as offensive, intimidating, malicious or insulting behavior, an abuse or misuse of power through means that undermine, humiliate, denigrate or injure the person to whom it is directed.

Harassment is unwanted conduct related to sex, gender reassignment, race or ethnic or national origin, disability, sexual orientation, religion or belief, age or any other personal characteristic which:

  • has the purpose of violating a person’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that person;
  • Or is reasonably considered by that person to have the effect of violating his or her dignity or of creating an intimidating, hostile, degrading, humiliating or offensive environment for him or her, even if this effect was not intended by the person responsible for the conduct.
  • Any individual can bully, be bullied or switch between the two, and others may be affected by viewing this behavior.
  • It is important not to confuse bullying behavior with firm supervision.  Bullying is undermining and destructive whereas effective supervision is developmental and supportive.  The latter may well include negative but constructive feedback.

3. Examples of bullying and undermining in clinical/practice based education

  • Undermining someone’s role, e.g. criticism in front of patients or other staff
  • Persistent or excessive negative feedback; unsubstantiated allegations
  • Asking trainees to perform tasks they have not been trained to do or work unpaid shifts
  • Undervaluing someone’s contribution (in their presence or otherwise)
  • Unrealistic expectations about workload, responsibilities or level of competence
  • Shouting or swearing at someone
  • Excluding, devaluing or ignoring an individual on purpose
  • Inadequate or absent supervision
  • Belittling or marginalization of trainees by senior staff from other professional group
  • Bullying of trainees by other staff pursuing targets

4. Responsibilities of trainers and other senior staff

  • Senior clinicians, educators and managers are responsible for ensuring that their organisations provide supportive working environments, free from bullying and harassment.  Such workplaces optimise patient safety, educational outcomes and staff wellbeing.
  • Trainers in East of England are expected to undertake regular training in equality and diversity.
  • Individuals who are told about or who witness bullying behaviour must ensure that timely, sensitive and appropriate action is taken.  Confidentiality should be respected.
  • East of England will provide support to resolve situations where bullying has been identified.
  • Trainees who raise in good faith an issue or grievance relating to bullying or harassment, or assists in the raising of such an issue, would be expected by East of England to be protected against victimisation both at the time and afterwards.

5. Guidance for trainees

Develop further your own awareness of equality and diversity issues with regular training in this area. This will help you recognise more clearly types of discrimination and recognise behaviours that are likely to lead to harassment and bullying

6. Speak to someone

Don’t be concerned or ashamed to tell people what’s going on. If you think that you are being subjected to bullying behaviour, or that it is taking place, then you should speak to someone about it in confidence to discuss how you might be able to deal with the problem.  Generally it is best to discuss and resolve the issue informally and locally first.

If may be an option talking to the person who is bullying you but only if you feel comfortable doing this. The bullying may not be deliberate and the person in question might not realise how their behaviour has affected you.

7. Who could you speak to?
Your first discussion should help you explore the issue and decide what to do next.  If the first person you talk to is not helpful then speak to someone else.

8. Keep a record/diary

Keep a diary of all incidents. These should often include a record of the date, time, any witnesses and how you felt about an incident. Keep copies of anything else that may be relevant for instance written communication (emails, letters) and notes from meetings.


9. Other sources of support and information 

  • Whistle-blowing Advice and Helpline for NHS and Social Care

  • BMA - Guidance on stopping harassment and bullying

  • NHS Employers - Guidance on bullying and harassment

  • National Advisory Group on Safety of Patients in England

Who to contact regarding bullying and harassment in the workplace:

  • Clinical Supervisor
  • Training Programme Director
  • Educational Supervisor
  • Postgraduate Centre – Medical Education Managers and Foundation Programme Administrators
  • HR
  • Employee Assistance Programme
  • Occupational Health
  • College Tutor
  • Clinical Tutor
  • Director of Medical Education
  • Head of School
  • BMA Helpline
  • Trainee Reps
  • Freedom to Speak Up Guardian 
  • Guardian of Safe Working
  • Professional Support and Well-being Service –

Acknowledgments: Professor Jan Welch, Director, South Thames Foundation School

Friday, 16 November, 2018
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Friday, 21 December, 2018