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Creating a positive workplace culture – #HammerItOut – Simon Fleming


Simon Fleming

My name’s Simon Fleming, I’m an Orthopaedic registrar. I’m also President of the British Orthopaedic Trainees Association which is known as ‘BOTA’.

What lead to developing the anti-bullying campaign, #HammerItOut?

So we developed the BOTA census where we asked about everything- from demographics, to what people wanted to do at the end of their training… and one of the areas that I pushed for focus on as Vice President at the time was bullying, harassment, and undermining. The aim, the initiative, to all intents and purposes. is to create a positive and just culture that is free from bullying, undermining and harassment. ‘Hammer It Out’ talks very much about the world of Orthopaedics but we’re now talking about ‘Cut It Out’ which is much more pan-surgical. But the goal is to try and really lead the way in saying there’s a culture in the NHS, in healthcare, where these behaviours not only happen, but to an extent are tolerated and we can do better, we can be better.

What has #HammerItOut achieved so far?

We’ve been pushing a social media campaign such that it’s been picked up both nationally and internationally by multiple organisations. Internationally, I’m being invited to speak on it in Canada, in Australia, so the world is really looking at at UK Orthopaedics as being a real trailblazer in trying to change these cultures. And again, a softer point is the fact that it’s kind of becoming part of the vernacular. So you hear in coffee rooms across the country I’m getting reports of people either saying something or starting to say something in a very joking, self-deprecating way someone goes, you know, “You better ‘cut that out’ “, “You better ‘hammer that out’ ” and actually, that’s great, that’s what we want. [As well] the joint Royal Surgical Colleges have empowered the JCST, the Joint Committee in Surgical Training, to create a working group to act on these behaviours.

What has been your experience of bullying within the healthcare profession?

I think there’s two sides to it. There’s what you experience, and what you perceive, and our data mirrors that. So personally, have I had experiences of not just bullying but undermining and harassment? Yes, I have. The biggest thing for me is, have I done it to other people? Yeah I think I have if I’m honest. Have I used my power to make someone do something that they’d rather not do? Well that’s bullying. So have I turned up when my junior doctor has said, ‘I’d really like to go have my lunch’ and have I said, ‘No, I want to do a ward round, now, because I’m free now‘? I think I probably have. It’s everywhere. But the first step is admitting that there’s a problem because then you can make a real change.

With current NHS pressures, is workplace bullying likely to worsen?

I think so. I think a lot of these behaviours come out when we’re stressed, when we’re tired, when we’re unsupported. When we’re at the end of our tether, you know, that last straw on the camel’s back and we all know this, when you’re tired and stressed and all the rest… but that doesn’t excuse it. We still need to be mindful of it. Do I expect to see it getting worse? Before ‘Hammer It Out’, I would have said yes… but now I would like to hope, I aspire, that actually the answer would be no because we will be more mindful of it. We recognise that these behaviours impact on recruitment and retention. So you know what? Let’s do something about it. Let’s make it better.

How have surgeons responded to the campaign?

Huge buy-in from the Orthopaedic community saying, ‘Yep, you know what? We can do this, we can make this better. We can make a change’, and the best bit is, it’s doing exactly what we wanted which is, it’s inspiring others. Again with that sort of, self-deprecating, orthopaedic humour. People are looking at us and going, ‘Wow… if Orthopaedics can take a long, hard look in the mirror and try and change this stuff, we better do something!’ I love that, I love that other specialities are looking at us and going: ‘We want to be like them’.


Simon Fleming is an Orthopaedic registrar and President of the British Orthopaedic Trainees Association (BOTA).



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