An independent investigation discovered that ambulance staff in the West Midlands had their ability to speak up as whistle-blowers suppressed for many years. .
Inadequate financial governance at West Midlands Ambulance Service (WMAS) was also revealed by the investigation, which NHS England had commissioned.
That included the lease agreement for the £60 million Sandwell Hub, which could cause the tax payer to lose out.
NHS England heard from five senior and former employees.
WMAS acknowledges that there is still much to learn, but claims that the report expresses confidence in the service's ability to address the issues brought up.
A finance director, medical, operational, and quality control staff were among the informants.
They communicated their concerns to the National NHS England Team through the Freedom to Speak Up program.
"Governance, probity, the difficulty of speaking up about these issues, and the alleged behavior of some senior leaders" were among the topics covered by the inquiry's terms of reference, which were overseen by Carole Taylor Brown.
Additionally, they examined whether senior staff members were receiving additional compensation in a proper manner and whether leasing of the ambulance hub in Sandwell complied with NHS regulations.
Despite a Freedom of Information request for the report's factual findings, NHS England has not yet made them public, and the BBC has only obtained its recommendations.
It is well known that KPMG, WMAS' auditor, stated that the project's financial viability was still at risk because the commissioning of the Sandwell business hub did not adhere to the ambulance service's own rules.
The trust was working under a tight deadline because it wanted the building to be open in time for the Commonwealth Games in Birmingham, but communications director Murray MacGregor acknowledged that WMAS did not adhere to the regulations to the letter.
He claimed that the move was justified because the organization was no longer operating out of buildings that weren't suitable for the job because it now had a modern structure.
The independent review suggests tightening up the processes for paying employees more money.
It also implies that the trust should reconsider who leads the compensation committee.
The trust chairman was in charge at the time of the report.
It stated that any requests for payment must expressly state the time and extent of the payments once they have been agreed upon.
WMAS claimed that no unauthorized payments had been made and that the report had found no evidence of wrongdoing.
The report suggests the trust board ensure that the lessons from its own governance review are internalized throughout the entire organization.
Former medical director Roger Cooke began criticizing WMAS's actions as early as 2010.
The remuneration committee had broken its own rules, according to an investigation that year.
Additionally, Dr. Cooke testified before the independent investigation in 2022, which came to the conclusion that "systemic issues influencing the speaking up culture in the trust" may exist. .
After I raised concerns, there was an assurance that they would be addressed, according to Dr. Cooke. .
More than ten years later, I come across a report that essentially restates the same conclusions. " .
The National Guardian Office (NGO) is conducting an investigation, which the Carole Taylor Brown 2022 report identified as having the potential to shed more light on the issue.
In February 2023, the NGO released its report.
It claimed that the culture at ambulance trusts was having a bad effect on employees' ability to raise issues.
It was informed by some ambulance workers that they had encountered bullying, harassment, and discrimination.
A number of ambulance staff allegedly testified, according to Martin Waite, a former councillor and WMAS paramedic who is twice cited in the NGO report.
He is attributed with saying: "I felt that nothing would happen if I reported them other than I would lose the trust of colleagues on whom I was clinically dependent. " .
WMAS deemed Mr. Waite's assertions to be unfounded. After being suspended for reasons unrelated to his allegations, he resigned before the investigation was finished.
The suspension and Mr. Waite's resignation were both confirmed.
50 employees reported having been physically abused by a manager in the most recent WMAS employee survey.
The trust claimed it had made this information public in an effort to encourage employees to come forward despite the lack of any evidence or claims of physical abuse on any of its systems.
Bullying has no place in this organization, and we're glad that two separate reports—from 2010 and 2022—have confirmed that there isn't any proof of systemic bullying. .
"There is also ample proof that employees do raise issues when they have them. .
"The independent review was useful in providing knowledge that we will use to enhance how we address such [a] issue on the infrequent occasions that it does occur. ".
Les Smith spent 20 years working for WMAS before advancing to risk manager.
He claims that because of the way he was treated, he attempted to jump from the building housing the ambulance service's headquarters but was pulled down when his coworkers saw him.
My life's proudest moment was when I was hired by the ambulance service. They killed me.
"They were aware of my diligence, but it didn't matter. It is their way or the highway, so you have to stick to the rules. ".
Seven suicides were reported over the previous five years, which led to concerns in 2019, the year he resigned.
According to WMAS, its investigations revealed that these suicides were not related to the workplace and that the main contributing factors were relationship and financial problems.
According to the trust, Mr. Smith had asked to return to work and an internal investigation into his claims had turned up no evidence of bullying.
The Carole Taylor Brown report's conclusions have been fully accepted by WMAS, and we are offering our full cooperation. We strive to improve in everything we do as a learning organization. " .
There are now 50 freedom to speak up champions on the hubs, and the trust has appointed a new executive director with responsibility for this issue.
The Freedom to Speak Up Guardian recently addressed our board and commended us for the work we have accomplished and the initiatives we have implemented, Mr. MacGregor said.
"Systemic problems may have existed, not that there are systemic problems," he continued, referring to the report's sole use of the word.
"The report is confident in the organization's ability to address the issues, even though it is clear that this organization still has some growing to do. " .
The review "did not make any recommendations for further areas of investigation, and did not identify a pervasive culture of bullying in the organization," according to NHS England. .
It made a number of suggestions for WMAS and NHSE, which are being implemented. .
"WMAS provided full cooperation for the review and accepted its recommendations. .
We collaborate with WMAS and hold regular meetings to assess the status of their improvement plan.