A culture of bullying at one of England’s biggest NHS trusts could put the care of patients at risk, a report has found.
An independent review of the University Hospitals Birmingham NHS Trust (UHB) has found the number of patient deaths at the trust is higher than would be expected and has warned that “if the cultural environment at UHB has not already affected mortality it is likely to be affecting the patient experience and morbidity”.
The report revealed “extensive complaints” had been made by staff about the organisation’s conduct and that “many were concerned about the ‘toxic atmosphere and bullying at all levels of management'”.
It said the report team “heard many examples of concerning comments following a range of topics, including issues over promotion processes, bullying of staff (including junior doctors), and a fear of retribution if concerns were raised”.
It also highlights concerns around staffing levels. In November 2022, 13.35% of nursing posts at the trust were vacant, compared with an England average of 10%.
It warns that “any continuance of a culture that is corrosively affecting morale and in particular threatens long-term staff recruitment and retention will put at risk the care of patients”.
The report chaired by Professor Mike Bewick, a former deputy medical director at NHS England, who is now an independent consultant, was commissioned last year after a number of complaints were raised about the trust which employs 22,400 people across several sites and operates four major hospitals in the West Midlands.
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Father of junior doctor: ‘Our lives stopped on 22 June’
It followed the death by suicide of Dr Vaishnavi Kumar, 35, who was working at the Queen Elizabeth Hospital Birmingham when she took a fatal overdose in June of last year.
“She wrote a letter,” her father, Dr Ravi Kumar, told Sky News. “She very clearly mentioned that she was doing this because of the QE hospital.”
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After taking the overdose she waited three hours to call an ambulance. Her father says that when paramedics arrived “she said under no circumstances was she going to the QE hospital”.
Dr Kumar says his daughter was “bright, fun-loving and compassionate” but things changed soon after she began working at the Queen Elizabeth Hospital.
Image: Dr Vaishnavi Kumar took her own life in June 2022
“She started facing this toxic environment and she started getting a bit more worried and tearful,” he said, adding sometimes when she returned from work she would say “people are belittling her and demeaning her”.
The report found there was “considerable unrest and anger at the trust’s response” to Dr Kumar’s death, both from her family and “the wider junior doctor community”.
It also found that “this was not the first death by suicide of a doctor at UHB”.
It revealed there was “disappointment and anger” from staff at a lack of senior representation by the trust at Dr Kumar’s funeral, and that the trust only formally wrote to her family two months after her death.
Shockingly, the report found a senior member of staff within medical staffing was unaware of Dr Kumar’s death and emailed the medic personally 26 days after her death to ask why she had been removed from her post and if she was still being paid.
The report concluded the case showed a need for “a fundamental shift in the way an organisation demonstrably cares about its staff as people”.
Dr Kumar’s father said: “It makes me angry and at the same time worried about other junior doctors who are going to follow her.
“Our lives stopped on the 22 June and it’s very hard. Each day is a struggle.
“Now my main worry is to stop it happening to others and that is why I want to bring this forward so people realise that there is a toxic atmosphere.”
A spokesperson for University Hospitals Birmingham said: “Dr Vaishnavi Kumar was a much loved and respected doctor, who was popular with colleagues and patients alike. Her unexpected death was a tragedy and our heartfelt condolences remain with Vaishnavi’s family.
“We have reflected on our response to Vaishnavi’s death, have learnt lessons from this, and are acting on them.
“Dr Kumar wants his daughter’s death to result in improvements in the support offered to all doctors in training and to see a change in the culture of the trust. We are pleased that he has agreed to work with the trust on this.”
Jonathan Brotherton, chief executive at University Hospitals Birmingham NHS Foundation Trust (UHB) said in response to the report’s findings: “Patients can continue to be confident that the care and treatment provided at our hospitals is safe. We are pleased that Professor Bewick’s overall view ‘is that the trust is a safe place to receive care’.
“We fully accept his recommendations and welcome the additional assurance that has been asked for through further independent oversight.
“There are a number of significant concerns that we need to, and have started to, address; we will continue to learn from the past, as we move forward.
“We want to develop a positive, inclusive work environment where people want to come to work, in a place that they are proud to work in, to do their very best for our patients. While we will not be able to fix things as quickly as I would like, we do need to do it as quickly as possible, for the benefit of patients and staff; I am committed to ensuring this happens.
“We must now focus on continuing to provide the best possible patient care, building a values-led culture and supporting our incredible colleagues.”
:: Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.
The King, Prince William and the Princess of Wales have attended the funeral of the Duchess of Kent.
The trio were joined by other royals at Westminster Cathedral for the requiem mass – a Catholic funeral – the first to be held for a member of the Royal Family in modern British history.
Image: Pic: Reuters
Image: Pic: PA
Image: Pic: Reuters
Katharine, Duchess of Kent, who became the oldest living member of the Royal Family on the death of Queen Elizabeth II in 2022, died at the age of 92 on 4 September.
Image: The Duchess of Kent at the Wimbledon tennis Championships in 2012. File pic: PA
It emerged earlier that the Queen had withdrawn from attending while she recovers from illness.
Buckingham Palace said on Tuesday that Camilla, 78, is recovering from acute sinusitis, with the withdrawal raising questions over her attendance for US President Donald Trump‘s state visit, which begins at Windsor on Wednesday.
Image: The King and Queen were due to attend the funeral together. Pic: PA
That visit is being hosted by the King, but the Queen is understood to be hopeful she will recover in time to attend all royal elements of Mr Trump’s trip, which includes a lavish state banquet.
A Buckingham Palace spokesperson said: “With great regret, Her Majesty the Queen has withdrawn from attendance at this afternoon’s requiem mass for the Duchess of Kent as she is recovering from acute sinusitis.”
The Duke of Kent was informed and was said to fully understand the decision, wishing her a speedy recovery.
The Queen had travelled down from Scotland this morning and is currently travelling to Windsor, where she will rest.
“Her thoughts and prayers will be with the Duke of Kent and all the family,” the spokesperson added.
During the service, Pope Leo XIV paid a personal tribute to the Duchess of Kent, praising her “legacy of Christian goodness” in a message delivered during her funeral.
In words read out by Archbishop Miguel Maury Buendia, the pontiff highlighted her “dedication to official duties”.
Image: Pics: PA
Prince Andrew and Sarah, Duchess of York, were seen approaching Westminster Cathedral for the service.
Image: Pic: Reuters
Former Formula 1 world champion Sir Jackie Stewart and actresses Rula Lenska and Dame Maureen Lipman were also among the mourners.
The parents of the Southport killer took delivery of a number of machetes and knives, which they tried to hide from him, the inquiry into the stabbings has been told.
Alice da Silva Aguiar, nine, Bebe King, six, and Elsie Stancombe, seven, were murdered at a Taylor Swift-themed class on 29 July last year by Axel Rudakubana, who was jailed for a minimum of 52 years.
He seriously injured eight more girls and two adults who had tried to stop him.
Nicholas Moss KC, counsel to the inquiryinto the killings, said the purchase of weapons by Rudakubana – referred to by the inquiry throughout as AR – is “important because it will highlight vulnerabilities in the law against the purchase of knives, crossbows and machetes”.
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Southport: Parents of victims speak
Killer ‘used dad’s details to order knife’
On the purchase of weapons, Mr Moss said it is “also important because it is one significant factor in the questions which we need to explore with his family, particularly his parents”, asking “What did they know of the weapons purchases?”
The inquiry was told that his father or mother appeared to have taken delivery of the knife that was used in the attack, and that it was ordered via Amazon under an IP address suggesting the use of a Virtual Private Network.
Rudakubana used his father’s details instead of his own when ordering the knife, which was approved by Amazon because the name and address provided were those of an adult and matched up with credit check agency information.
Image: A knife identical to the one Rudakubana used in the Southport attack. Pic: Merseyside Police
Mr Moss said the package was shipped to an “Ax Rud” at his home address near Southport, arriving at around 5.40pm on 15 July 2024.
Ring camera footage from the property of Rudakubana’s next-door neighbour showed the delivery, but the recipient could not be seen.
The driver entered the recipient’s year of birth as 1978 and confirmed that they appeared to be over the age of 25.
Rudakubana’s father’s date of birth is in 1975, and his mother’s is in 1972, Mr Moss told the hearing.
‘Parents accepted – and hid – weapon deliveries from son’
Mr Moss then said Rudakubana’s parents had accepted deliveries of weapons and hidden them from him on multiple occasions.
Image: A machete taken by police after the attacks. Pic: Merseyside Police
A June 2023 delivery of a 22-inch machete – ordered using the driving licence of a woman named Alice born in 1991 and living in Sunderland – was found on top of the wardrobe in Rudakubana’s parents’ bedroom in sealed packaging.
In his statement to Merseyside Police after the attack, Rudakubana’s father said he had signed for a parcel containing knives that was addressed to someone with a British-sounding name, and he hid the parcel on top of his wardrobe despite his son asking for it.
An October 2023 order of a machete with a 16.5-inch blade – ordered using a driving licence for Samuel, a black man born in Nigeria in 1961, living in Uxbridge – was found by the police after Rudakubana’s prosecution, still in its packaging and unopened.
Rudakubana ordered a third machete that month, called a Kukri Congo 488 JKR with a blade length of 30.5cm from Huntingandknives.co.uk, again using Samuel’s driving licence.
That machete was found in the search of Rudakubana’s home in a black holdall under the bunk beds in his bedroom.
Image: The inquiry is taking place at Liverpool Town Hall. File pic: PA
‘Parents scared of Rudakubana’s behaviour’
The inquiry heard that Rudakubana’s parents had a “fear” of their son’s response if they asked him questions about packages or attempted to tidy his room.
Mr Moss said they were scared that he may be violent towards them, towards his older brother or cause damage to the house, and that they had noticed a “marked deterioration” in his behaviour after being excluded from the Range School for possessing a knife in 2019.
“However, it may be said to be apparent that AR’s parents were aware of other aspects of AR’s conduct that might have been expected to give rise to a concern,” he added.
The inquiry has asked Rudakubana’s parents about any steps that they took to recover knives from their son, and whether they considered reporting the incident to the police or any other agency.
A Labour peer has claimed he was “discreetly” told to “shut up” by Number 10 after issuing warnings about the appointment of Peter Mandelson as US ambassador.
Maurice Glasman, who was the only Labour figure to attend Donald Trump’s inauguration, said he was shown “photos of Peter Mandelson blowing out birthday candles with Jeffrey Epstein” while in the US in January.
The peer told Sophy Ridge on the Politics Hub that he reported this back to Downing Street, and was given a “discreet suggestion to basically shut up about that”.
Lord Mandelson was sacked as the UK’s ambassador to the US last Thursday after details of his close relationship with disgraced financier Mr Epstein emerged in the media.
He had always admitted to having known Epstein, but emails between Lord Mandelson and the convicted paedophile showed the diplomat had sent messages of support even as the financier faced jail for sex offences in 2008.
Lord Glasman, who founded the Blue Labour movement in 2009 as a counter to New Labour, told Sophy that he “held the line” on Lord Mandelson even as he was presented with photographs of the ambassador and Epstein together.
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Image: Peter Mandelson was sacked as the UK’s ambassador to Washington on Thursday. Pic: PA
He said he “reported back to No 10, that really I would think again about this appointment because really [his dismissal] was bound to happen”.
“It was not out of the clear blue sky, was it?”
The peer said he was asked to send back a report on the matter, which he did, and “that was that”.
“I did say when I got back, I’d think again about this publicly. And then I did get a discreet suggestion to basically shut up about that. And I did.”
Sir Keir Starmer said on Monday he would have “never appointed” Lord Mandelson as US ambassador if he knew then what he knows now.
The prime minister said Lord Mandelson went through a proper due diligence process before his appointment.
But, he added: “Had I known then what I know now, I’d have never appointed him.”
Sir Keir said he knew before Prime Minister’s Questions on Wednesday that Lord Mandelson had not yet answered questions from government officials, but was unaware of the contents of the messages that led to his sacking.
He said Lord Mandelson did not provide answers until “very late” on Wednesday, which was when he decided he had to be “removed”.
Lord Mandelson has said he regrets his relationship with Epstein, claiming repeatedly he wishes they had never met.