What to Do About Bullying at Work

Ask for Honesty and Comprehensive Details

It is important to remember that doctors may also find it difficult to give criticism but may feel obliged to do so in order to protect patients. Accordingly, they may feel reticent and may only offer brief details of their concern. Invite them to give as much detail as possible and be in full possession of the facts before considering a response. Effective learning is only likely if the feedback is comprehensive, intelligible, and trusted.

Turn the Discussion into a Learning Opportunity

Establish how you could do things differently in future. Set learning objectives to help you achieve the necessary changes to your practice. Revisit the situation with your clinical supervisor once you feel you have learnt from the criticism and take the opportunity to demonstrate that you are able to manage negative feedback in a mature and useful fashion.

Thank Your Critic

Thanking the person that criticises you may be instinctively difficult but will show them that you are serious about self-improvement and optimising patient care, rather than becoming defensive and rejecting their well-intentioned advice.

Reflective Writing

Self-reflection is now a requirement of most training programmes and is stated as one of the GMC’s Duties of a Doctor. This usually takes the form of written reflective pieces submitted to online portfolios. Ensure that you follow guidance on entering information into ePortfolios, such as that provided by NHS England.

Discuss with a Trusted Colleague

A neutral third party may offer a different view of the criticism and may disagree that it was unjustified and / or ill-intentioned. They could suggest ways in which the advice could be used productively. If they agree that the criticism is unfair or has been inappropriately delivered (i.e. in a way designed to undermine or intimidate) then consider a discussion with a senior colleague such as an educational or clinical supervisor.

Speak to a Freedom to Speak Up Guardian

The NHS Standard Contract requires every NHS Trust in England to have a Freedom to Speak Up (FTSU) Guardian. Their primary job is to support workers in raising concerns about patient safety, bullying, or workplace issues when they feel unable to use standard management routes, and they provide confidential advice, make sure raised issues are investigated and that the worker receives feedback on the outcome and help ensure staff do not face negative consequences or victimization for speaking up.

One can generally find local FTSU Guardians via your Trust's intranet, HR department, or FTSU portal.

Speak to a Senior Colleague.

Before pursuing a formal complaint, try talking to a senior colleague. This can be any of the following, depending on where the undermining occurs:

• Educational Supervisor

• Clinical Supervisor

• Clinical Director

• Medical HR

• Training Programme Director / Head of School of Surgery / Postgraduate Dean

Make A Formal Complaint

If informal methods fail or the bullying or harassment is severe, one should initiate a formal complaint under one's specific NHS Trust’s Bullying and Harassment Policy. This can be done by writing a formal letter or email to your line manager detailing your complaint. If your line manager is the one bullying you, submit your complaint to their manager or directly to your local HR department.

Resident surgeons in training in England can also use the national Complaints Policy for Postgraduate Medical and Dental Education (PGMDE). This was reviewed and updated in 2025 with a commitment that complaints and concerns will be investigated in an unbiased, transparent, timely and appropriate manner. The outcome of any investigation, along with any resulting actions, will be explained to the complainant.

More details can be found at Combined PGMDE and Pharmacy Complaints and a copy of the complaints form for submission of complaints can be found at Complaints Form.

Try to separate the just from the unjust. We all need to learn from our mistakes, even if the rebuke was unreasonable. If harsh words are spoken, accept them and move on. Replying with a ‘thank you’ can often make the underminer see the error of their ways.

If your supervisor is not being supportive, spell out what you want them to do and why.

First of all, it is best to talk it over with someone you can trust. Sometimes, what seems like undermining might not be.

Take No Further Action - If the undermining is an isolated event, you may not want to take any action. This should be on the understanding that it does not happen again. The underminer must realise their actions, explain their point of view, and offer an apology.

If the behaviour does happen again, speaking to the perpetrator can be highly effective. Some undermining is not deliberate. Arrange a meeting in private and take along a trusted companion. Plan what you are going to say beforehand to explain how their actions made you feel. Stay calm and polite. Afterwards, make a written record of the date, time, venue, persons present and what was discussed at the meeting.

Make a note of each episode of undermining and any associated meetings. Collect any documents that may back this up, especially emails. This will be valuable evidence if the undermining persists and will also allow you to reflect on the events.

Before pursuing a formal complaint, try talking to a senior colleague. This can be any of the following, depending on where the undermining occurs:

• Educational Supervisor

• Clinical Supervisor

• Clinical Director

• Medical HR

• Training Programme Director / Head of School of Surgery / Postgraduate Dean

• Speak Up Guardian

Make a formal complaint in writing, backed up with written evidence.

Vanderbilt's research shows that as most unprofessional behaviours in the workplace are anomalies, early, informal conversations are more likely to have a positive impact than more formal approaches.

Therefore, when single and low-severity matters arise, Vanderbilt therefore recommend an informal, peer-to-peer "cup of coffee" conversation as first stage where a respected peer or department leader sits down with the individual to bring the specific incident to their attention in a respectful fashion and offer support or resources if needed.

The aim is to help the protagonist reflect on their behaviour and impact but with the aim of collaborating with them on restoring the working relationship in a professional and supportive manner. This could entail agreeing the boundaries of working relationships and set professional behaviour expectations both parties can agree to and work on.

If you are not able to speak to the protagonist directly, other options include speak to your line manager who can provide you with support and guidance and help you work through the best approach to resolve the issue at an early stage. Both your Trade Union representative and Freedom to Speak Up Guardians can also provide support and guidance and can speak to HR and/or your line manager with you or on your behalf to agree a way forward.

If you are going to approach a colleague in this way, it is worth preparing in advance by answering the following questions:

• How did the incident make you feel?

• Were these behaviours professional and civil?

• How can you approach your colleague to establish professional working boundaries between you?

• What would you say to your colleague to explore this in a professional manner?

• What behaviours would you like to see upheld by yourself and colleagues?

• How can you maintain these professional working behaviours between your colleague and yourself?

If a pattern of unsolicited complaints or reports begins to emerge over a set period, the organization implements a Level 1 intervention in which a manager presents the concerns (such as a series of complaints) to the employee concerned and encourages them to reflect on what might be behind the emerging pattern.

The focus of this stage is not to be punitive; rather the aim is to encourage the employee to self-reflect and be aware of their actions and impact on others. The learning comes when the primary causes behind the behaviours are understood and the employee reflects and learns what different approaches may be appropriate in the future. Primary causes can include high pressure at work, unmanageable workloads, incivility under pressure.

This situation is within your control to address directly with the clinical senior manager or using the avenues of support available informally. The aim to raise awareness about how this behaviour is making you feel before it escalates into a situation that causes yourself or others harm. As another aim is to get the working relationship back on track and establish professional working behaviour expectations you can both agree and work on. As Vanderbilt state, "most clinicians respond to such awareness interventions."

One can start this stage by approaching your senior clinical manager directly, informing them about the behaviour/ incident that has caused you concern and how it has made you feel. The focus should be on agreeing a better way of working together and agree to move forward together.

If you are not able to speak to the senior clinical manager directly, other options include your line manager, Freedom to Speak Up Guardian, local union representative, or trusted colleague.

If the pattern persists and the Level 1 awareness intervention fails, a formal leader such as a Department Chair or Chief Medical Officer conducts a guided intervention.

This still requires a coaching approach to why the previous approach has not worked, exploring the underlying issues still influencing the individual and refreshing the agreed approach that will be put in place by both the employee and the line manager. Again, the aim is to establish a mutually agreed-upon, written corrective action plan with specific expectations and timelines This prompts the individual to take responsibility for contributing to resolving the matter within a framework of support from the line manager and an agreed review period to keep focus on resolving the matter. A supportive action plan can be used to outline interventions, support, expectations and review period.

If you are not able to speak to the Department Chair or Chief Medical Officer directly, other options include your line manager, Freedom to Speak Up Guardian, local union representative, or trusted colleague.

This final stage is reserved for individuals who fail to respond to Level 1 and Level 2 interventions or for egregious, initial single offences that amounts to misconduct and therefore requires escalation to the formal disciplinary level.

When such egregious offences occur, formal escalation is the most appropriate route. Approaching the employee directly may not be feasible or the most appropriate action. You may need to ask colleagues immediately to help you de-escalate or to help remove you from the situation. The incident should be escalated to your line manager immediately in order to enforce compliance, ensure patient safety, and protect the organization's standards.

There is a spectrum of actions that may be appropriate for you to take varying from immediate reporting of a rape to the police, to keeping notes in case there is a pattern of behaviour that would cause you to act at a later date.

• Build up a picture of what is going on by keeping a note of dates and times of each incident; what happened and what was said. Keeping a log can show you and other people that you are experiencing a pattern of behaviour. One incident on its own may seem ‘trivial’ but things that might appear insignificant can have a cumulative effect.

• Note any friends or witnesses who saw what happened or the effect on you.

• If you go to your GP, a counsellor or other service because of the harassment then make a note of this too.

• Keep copies of any texts or emails the harasser sends to you; screenshots of any social media and web-based incidents; and photos, for example of any stalking behaviour. Find out how to take a screenshot from the device you are using (phone, pc, mac, android).

Depending on the circumstances you may wish to take more direct action.

• If the person is simply unaware of the effect they are having, you may be able to get them to stop by telling them to do so. Let them know that it is not right; you do not want their attention; and dislike their behaviour. You could ask someone else to do this for you such as a trusted colleague. You could also put this in writing (keep a copy).

• Check out workplace policies covering, for example, sexual harassment/violence at work, health and safety at work, dignity at work, equal opportunities/gender equality, grievance, and disciplinary procedures. Many organisations have formal procedures for dealing with sexual harassment. These documents describe the procedures and the steps to take.

• If informal methods do not work or are not safe to try, you may have to make a formal complaint to your employer.

• You could report the perpetrator to the police. If someone touches you on an intimate part of your body, this is a sexual assault. If someone is following you outside work, or harassing you through calls, texts, or emails this could be defined as stalking if there are two or more incidents causing you to feel fear and alarm. Sexual assault and stalking are criminal offences.

• You may feel it is appropriate to report to the GMC or Nursing and Midwifery Council if the perpetrator is a registered professional.

Bystanders can stop workplace sexual harassment by safely interrupting the behaviour as it happens. Right To Be have developed the 5 Ds of Bystander Intervention that suggests:

• Direct: Address the harasser calmly and immediately. Tell them their behaviour is inappropriate (e.g., "That's not appropriate," or "Stop, you're making them uncomfortable").

• Distract: Interrupt the situation without acknowledging the harassment directly. You might spill a drink, ask the target a work-related question, or start a new conversation to separate them.

• Delegate: If the situation is intimidating or feels unsafe, get help from someone in authority. Report the behaviour immediately to HR, a line manager, or building security.

• Delay: If challenging the behaviour in the moment is too dangerous, check on the affected colleague afterward. Ask if they are okay, let them know what you saw, and offer to support them in reporting it.

• Document: Write down exactly what you witnessed—including the date, time, location, and the names of those involved. Offer your notes to the targeted colleague, as this will help if they decide to file a formal complaint.