Exclusive: Trust execs accused of creating a ‘cult of the individual’

It is understood multiple current and former staff members at Bolton Foundation Trust, including people in senior positions, have been in contact with NHS England and the Care Quality Commission in recent months.

The claims include bullying and intimidation of people who raise freedom to speak up concerns and concerns that a “cult of the individual” is developing in the executive team.

The trust says “any concerns, comments and feedback from staff are considered carefully, understood, and addressed in line with our core values (vision, openness, integrity, compassion and excellence)”.

The claims include;

• a dramatic worsening in leadership culture at the trust, particularly around the FTSU process and people who speak up being bullied, side-lined and silenced;

• that investigations and meetings are stage-managed and tightly controlled by executives, with constant “sugar-coating” and positive spin on board reports, and intolerance of people who disagree;

• specific allegations about the leadership style of the deputy CEO/chief people officer James Mawrey, including that he has inappropriately intervened in FTSU cases; and 

• that Mr Mawrey’s style has previously been described as “Machiavellian” by CEO Fiona Noden. A trust source told HSJ this was said as a joke and meant he was good at seeing worse case scenarios and getting things done.

No findings have been made yet. NHSE and the CQC said they are taking the issues seriously and considering next steps. It is not known if Ms Noden or Mr Mawrey will respond to any allegations reviewed as part of this process.

Bolton FT was rated “outstanding” for leadership by the CQC in 2019, under former chair David Wakefield and chief executive Jackie Bene.

PwC review of governance concerns

The claims received by regulators also include concerns about governance processes, and HSJ understands these are already the subject of a trust-commissioned “lessons learned” review by consultancy firm PwC.

One issue being reviewed is the way in which a senior individual resigned from the trust last autumn.

It is understood the individual, referred to as X in internal emails, was deemed unsuitable for their role, and this view was supported by an independent investigation.

However, when X made a series of counter-allegations against several senior people at the trust, which were found to be unsubstantiated by the same investigation, they were able to resign with a financial settlement for lost earnings and having signed a non-disclosure agreement.

It is understood the trust wanted to avoid a messy employment tribunal, but some senior figures including former chair Donna Hall, believed the individual should have been dismissed and that proper processes were not followed. There appears to have been a breakdown in relations between key board members after this episode.

Ms Hall announced her retirement in October last year and stepped down in March. She was approached for comment.

There were further internal tensions around the process of appointing new chair, Niruban Ratnarajah, who joined the trust in April this year. Whistleblowers have told regulators the council of governors was “coerced” into approving the appointment, and that due process was not followed.

‘Cult of the individual’

One whistleblower told HSJ: “When Fiona [Noden] appointed James [Mawrey] she said she’d done it because he was ‘Machiavellian’ which seemed a very odd thing to boast about. It seemed to mean that he knows how to get things done but doesn’t do them by the book. But not doing things by the book isn’t really what you want from the exec director of people and deputy CEO.

“It’s [since] become like a cult of the individual. The CEO and deputy are like the selfie king and queen, spending lots of time promoting their image. But what’s underneath has become really nasty and people feel afraid to speak up.”

Another source said: “There was a change of culture which seemed to develop during the pandemic where the truth was constantly being massaged, difficult questions were ignored, board meetings were being rehearsed and stage-managed, and it all became about the trust’s image. There’s no way that Bolton would get outstanding on leadership again.”

After the trust was contacted by HSJ, Ms Noden issued an internal message to staff saying: “A small number of people have contacted a national media source to raise concerns about their experiences in the workplace.

“These concerns have also been shared with our colleagues at NHS England and the Care Quality Commission who are in the process of determining next steps. We will of course be working closely with them to fully understand the issues and any action we can take to make improvements here in Bolton.

“Issues have also been raised about the leadership culture of our organisation, and leadership style of some staff within the organisation, which as your chief executive, I am deeply concerned about…

“We are lucky enough to have regular information from sources including our staff survey, quarterly pulse checks and Freedom to Speak Up; that tell us what you’re feeling and experiencing at work. This feedback enables us to learn from the great, and work together to improve any areas that could be better. If we find that there are instances where our culture is not where it should be, will we work to overcome this together. “

Regulators looking at concerns

When asked to respond, the trust pointed to last year’s staff survey results, which showed the trust performed slightly better than its peer group for the percentage of staff feeling bullied or abused by managers, and better than average for staff feeling able to raise concerns.

The trust said the survey showed that “a significant proportion of staff working in the Trust believe the organisation has compassionate leadership and line management”. Many of the staff survey scores have declined on previous years, although this is broadly in line with the national trend.

It also referenced improvements that had been made in maternity services as a result of concerns being raised by staff, and included a statement from Malcolm Brown, a NED who oversees the FTSU process who said: “We are really proud of our freedom to speak up process and actively encourage our staff to make use of it. We have 44 champions who encourage and promote a culture where people can speak up.” (see below for full statement).

NHSE’s regional team said in a statement: “We are aware of the concerns raised and will be working with the trust and our partners to address those issues and resolve them as quickly as possible.”

A CQC spokeswoman said: “We have received some concerns from staff at Bolton NHS Foundation Trust about culture and leadership at the trust. We are following up on those concerns to fully understand the issues raised and determine further action on our part. We take all information of concern shared with us seriously and are keeping the staff who contacted us informed.”