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Harassment and discrimination in the National Health Service (NHS) has steadily increased over the past 5 years with London being the worst performing region. There is a lack of data and research on the impact this is having on staff health and job satisfaction. Such data are necessary to inform the development of effective workplace interventions to mitigate the effects these experiences have on staff.
Aims
Examine the impact of harassment and discrimination on NHS staff working in London trusts, utilising data from the 2019 TIDES cross-sectional survey.
Method
In total, 931 London-based healthcare practitioners participated in the TIDES survey. Regression analysis was used to examine associations between the sociodemographic characteristics of participants, exposure to discrimination and harassment, and how such exposures are associated with physical and mental health, job satisfaction and sickness absence.
Results
Women, Black ethnic minority staff, migrants, nurses and healthcare assistants were most at risk of discrimination and/or harassment. Experiencing either of the main exposures was associated with probable anxiety or depression. Experiencing harassment was also associated with moderate-to-severe somatic symptoms. Finally, both witnessing and experiencing the main exposures were associated with low job satisfaction and long periods of sickness absence.
Conclusions
NHS staff, particularly those working in London trusts, are exposed to unprecedented levels of discrimination and harassment from their colleagues. Within the context of an already stretched and under-resourced NHS, in order to combat poor job satisfaction and high turnover rates, the value of all healthcare practitioners must be visibly and continuously reinforced by all management and senior leaders.
Since April 2016 a new generation of Saudi leaders led by Crown Prince Mohammed bin Salman has transformed the traditional state–society relationship, specifically with the launch of the National Transformation Programme 2020 and Saudi Vision 2030. In turn, this has resulted in the Kingdom’s predominantly youthful, and often well-educated, population re-examining the existing ‘social contract’ at a time of significant socio-economic change. This is because the economics of the social contract have come under increasing strain as a result oil price fluctuations, thereby impacting on Saudi Arabia’s economy, in particular on the related issues of employment, housing and healthcare. With many young male Saudis struggling to enter the domestic labour market and get on the property ladder, it is imperative to examine societal attitudes towards the changing role of economic structures and policies in shaping citizen–state relations – that is, to evaluate the ways in which the existing Saudi social contract is evolving in light of recent economic realities. Moreover, following the 2014 drop in oil price, the Saudi government started to impose fiscal restraint, presenting a significant challenge since its citizens are accustomed to government largesse.
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