Questions concerning the Sturrock report: FOI release

Information requested

You asked for:
Does the Scottish Government accept that ALL points noted by Mr Sturrock (reflections , recommendations etc.) were worthy of review to establish whether or not further action was needed?

Has the Scottish Government created an action list , punch list or similar document, against which, ALL of Mr Sturrock’s points, including ‘reflections’, can be reviewed or has such a document been created by and shared by NHSH? If available please provide a copy.

If no such document exists (as item 2) , what is the basis of the confidence stated in FOI response FOI/202999911317, that ‘NHSH gave careful consideration to all recommendations and noted which of these were reflections rather than specific actions’.

Was Mr Sturrock consulted by the Scottish Government and/or NHSH , to confirm that the distinction NHSH have made between points requiring ‘specific actions’ and those referenced above as ‘reflections’ fully reflect Mr Sturrock’s intent within his report?

The undernoted clauses of Mr Sturrock’s report, represent a sample of issues not specifically addressed via the strategy document a Culture Fit for the Future. Please provide an FOI response to the questions asked in each case: 

a. In relation to Mr Sturrock’s ‘reflections’ in Clauses 26.9 and 35.34 regarding ‘Confidentiality’ , has the Scottish Government, in consultation with NHSH, established whether there is indeed a confidentiality issue and whether NHSH have undertaken to address this.

b. With reference to Clause 27.12 (Concerns regarding GP’s) Mr Sturrock’s ‘reflection’ in relation to Nairn practice included a comment ‘urgent work seems to be needed’ and also that ‘skilled mediation would offer a start’.

With reference to Clause 27.16 (Radiology) Mr Sturrock’s ‘reflection’ included the comment ‘This whole situation has been unhealthy and would benefit from an urgent rigorous independent assessment and review (and possibly mediation)’

In both of the above the theme of urgency and the possible benefit of mediation appears to be a common ‘reflection’ of Mr Sturrock. Given the urgency expressed, has the Scottish Government, in consultation with NHSH, established whether, and how, NHSH have addressed (or plan to address) these issues ?

c. With reference to Clause 27.20 (Chaplaincy) Mr Sturrock’s reflection was ‘I suggest that a review of the leadership of the chaplaincy function may be necessary’.

Has the Scottish Government, in consultation with NHSH, established whether there is a need for such a review and whether NHSH have undertaken such a review?

d. In clause 35.32 ( concerning Trauma support /assessment ) Mr Sturrock ‘reflected’ that ‘ there needs to be a funded fast-track service’.

Has the Scottish Government, in consultation with NHSH ,established whether there is validity in the comments made and whether NHSH have any proposed actions in this respect? Is the Scottish Government aware of any additional provision having been established since May 2019?

 

Response

1. The answer to your question is:
Yes, the published Scottish Government response to the Sturrock Report, that can be viewed at https://www.gov.scot/publications/scottish-government-response-report-bullying-harassment-nhshighland/ clearly states that: ‘It is important now that we take the opportunity to reflect on these findings and that we engage constructively in dialogue, in the spirit of the Review, to support implementation of the recommendations’.

The Scottish Government notes that Mr Sturrock articulated, in Chapter 9 of the review, how to navigate the substance of the review and the spirit with which he had made recommendations about possible remedies: 

“9.1 My approach to the substance of this review is to describe what I have heard and read and to try to identify the circumstances which have led to the allegations of bullying and harassment, and to add my observations about these. This includes what, in terms of my remit, I “understand to be the cultural issues, if any, which have led to any bullying or harassment and [to a situation] where such allegations apparently cannot be raised and responded to locally.
and
“9.4 I also seek to “identify proposals and recommendations for ways forward which will help to ensure the culture within NHS Highland in the future is open and transparent and perceived by all concerned in this way.

9.5 Thus, I seek to suggest possible remedies. As I have mentioned, these include both the restorative (seeking to address past and present issues) and the preventative (looking to the future and avoiding continuation or repetition of problems). These proposals are however merely signposts for others to follow in what needs to be an organisation-wide collaborative project of renewal.”

The published Scottish Government response to the report, supports this approach and sets out the Scottish Government expectation that it is for NHS Highland to consider the conclusions and recommendations and how these can be positively applied in the Board.

In view of wider implications, the Scottish Government note that Chapter 1, paragraph 10 of Mr Sturrock’s report states that: ‘…[T]his report is designed to enable the Cabinet Secretary to reach conclusions about the matters I have explored in connection with NHS Highland and, if she wishes to do so, to act on my proposals and invite others to do so….’

With this in mind, the Cabinet Secretary wrote on 20 May 2019 to all health boards in Scotland asking to consider the findings and look again through actively engaging with staff, at the effectiveness of their own internal processes for handling concerns, leadership and governance.

2. The answer to your question is:
No, the Scottish Government have not created an action list as the report clearly states (in Paragraph 1.10) that it is for NHS Highland to take matters forward: ‘…It is also written with a wider audience in mind including those in NHS Highland who will need to take matters forward...’

In the Scottish Government Response, Ms Freeman clearly stated that she expects the Board of NHS Highland to carefully consider this substantive report and actively engage with staff at every level to consider its conclusions and recommendations and how these can be positively applied in NHS Highland. Ms Freeman also states that: ‘…[T]he Scottish Government also expects that the board heeds the Review’s recommendations in appointing an appropriate executive lead (or leads) to oversee the short to medium team response…

As well as the business as usual processes of Board Annual Review and Annual Staff Governance Monitoring, the Scottish Government continues to take an active interest in how NHS Highland engages with all parties as it takes forward the Culture 2020 Action Plan. The Health Secretary has visited NHS Highland a number of times to examine implementation of short-term actions and to hear how longer-term action planning is progressing.

3. The answer to your question is:
As mentioned above, the Cabinet Secretary and Senior Scottish Government Officials have met with the Board several times to check on the progress of the Board’s action plan being developed to implement the proposals made in the Sturrock report. Additionally the Scottish Government is undertaking an ongoing review of the development of the board’s Culture Plan. On this basis, the Scottish Government maintains the view that NHS Highland are giving careful and holistic consideration to the recommendations set out in Mr Sturrock’s report, in the spirit in which he articulated that the board and others should engage with the review and its findings.

As advised in the response to question 1, Chapter 9 clearly articulates the anticipated approach that the board should take. The Scottish Government’s use of the term reflection was therefore used to refer to the observations that were included in the report for consideration.

4. The answer to your question is:
No, Mr Sturrock was not consulted by the Scottish Government to confirm that the distinction NHS Highland have made between points requiring ‘specific actions’ fully reflect Mr Sturrok’s intent within his report.
This was an independent review that had clear terms of reference developed by Mr Sturrock and the Scottish Government. As advised in our response to your first question and to question 3; Mr Sturrock advises that his report aims to reflect what has been seen and heard during the review to set the scene for ongoing conversations. These observations together with his recommendations are intended to offer signposts for an organisational-wide collaboration project of renewal.

The Scottish Government use of the term reflection was therefore used to refer to the conclusions and observations that were included in the report for the Board to consider.

5.a) The answer to your question is:
The report reflects Mr Sturrock’s conclusions that, as outlined in Chapter 9.5, are ‘signposts’ for the Board to consider. As advised in the response to Question 3, Chapter 9 clearly articulates the anticipated approach that the board should take.  The Scottish Government use of the term reflection was therefore used to refer to the observations that were included in the report for consideration.
With regard to the question about addressing the specific points in paragraph 26.9 and 35.34. It is for NHS Highland as the employer to consider the findings outlined at paragraphs 26.9 and the proposal in 35.34.

b) The answer to your question is:
As noted above, in accordance with the terms of the review itself, and the Scottish Government response, it is for NHS Highland to consider these specific points in terms of the overall objective of undertaking an organisation-wide collaborative project of renewal.

Notwithstanding that Mr Sturrock has noted that some issues appear urgent, this is because, as he has noted in Paragraph 21.4 of the Report, he was presenting information and conclusions on the basis of what he was told : “What follows bears on the general situation and not any specific case. I have drawn on what I have been told and readily recognise that there will be nuances and other perspectives of which I am not aware”. The Scottish Government Response is therefore clear that given the wide-ranging nature of the proposals, will be important for NHS Highland to urgently prioritise the action it is taking forward.

As advised in the response to Question 2. Accordingly, the Scottish Government is of the view that NHS Highland are giving careful consideration to all recommendations. As mentioned above, the Cabinet Secretary and Senior Scottish Government Officials have met with the Board several times to check on the progress of the Board’s action plan being developed to implement the proposals made in the Sturrock report.

c) The answer to your question is:
As noted above, in accordance with the terms of the review itself, and the Scottish Government response, it is for NHS Highland to consider the conclusions and recommendations and how these can be positively applied in the Board.

As advised in the response to Question 2. The Scottish Government is confident that NHS Highland are giving careful consideration to all recommendations. As mentioned above, the Cabinet Secretary and Senior Scottish Government Officials have met with the Board several times to check on the progress of the Board’s action plan being developed to implement the proposals made in the Sturrock report.

d) The answer to your question is:
As noted above, in accordance with the terms of the review itself, and the Scottish Government response, it is for NHS Highland to consider the conclusions and recommendations and how these can be positively applied in the Board.
As advised in the response to Question 2. The Scottish Government is confident that NHS Highland are giving careful consideration to all recommendations. As mentioned above, the Cabinet Secretary and Senior Scottish Government Officials have met with the Board several times to check on the progress of the Board’s action plan being developed to implement the proposals made in the Sturrock report.

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